Documentation that order was given to discontinue prophylactic antibiotics within 24 hours of surgical end time, non-cardiac procedure (PERI 2)
CPT4 code
Name of the Procedure:
Discontinuation of Prophylactic Antibiotics within 24 Hours of Surgical End Time (Non-Cardiac Procedure)
Summary
This protocol involves stopping the administration of preventive antibiotics within 24 hours after the completion of a surgical procedure that is not related to the heart. This is done to prevent antibiotic overuse and reduce the risk of developing antibiotic-resistant infections.
Purpose
The procedure addresses the prevention of postoperative infections while minimizing unnecessary antibiotic use. The goal is to decrease the incidence of antibiotic resistance and reduce potential side effects from prolonged antibiotic administration.
Indications
- Patients undergoing non-cardiac surgical procedures.
- Individuals who have received prophylactic antibiotics to prevent surgical site infections.
- Patients who meet criteria for infection risk reduction post-surgery.
Preparation
- Review the patient's medication and allergy history.
- Inform the patient about the discontinuation plan for antibiotics ahead of the surgery.
- Ensure proper intraoperative antibiotic dosing and timing.
Procedure Description
- Administer prophylactic antibiotics appropriately before and during the non-cardiac surgical procedure.
- Closely monitor the patient during surgery and document the end time of the operation.
- Within 24 hours of the surgical end time, give an order to discontinue the prophylactic antibiotics.
- Continue to monitor the patient for any signs of infection or adverse reactions.
No specific tools or equipment are needed for discontinuation itself. The surgery may involve various surgical instruments and standard monitoring devices in the operating room. Anesthesia or sedation details depend on the specific surgical procedure performed.
Duration
The discontinuation order is issued within 24 hours following the end time of the surgery.
Setting
Typically in a hospital or surgical center with access to appropriate postoperative care facilities.
Personnel
- Surgeons
- Nurses
- Pharmacists
- Anesthesiologists
- Infectious disease specialists, if necessary
Risks and Complications
- Potential for postoperative infections if antibiotics are stopped too early.
- Adverse reactions to antibiotics if administration is unnecessarily extended.
- Development of antibiotic-resistant bacteria.
Benefits
- Reduces the risk of developing antibiotic-resistant infections.
- Minimizes side effects associated with unnecessary antibiotic use.
- Promotes efficient recovery by avoiding complications from prolonged antibiotic exposure.
- Benefits are typically realized soon after the antibiotics are discontinued, provided there are no signs of infection.
Recovery
- Regular monitoring for signs of infection.
- Follow-up appointments as needed based on the surgical procedure performed.
- Patients may resume normal activities as advised by their healthcare provider.
- Instructions for wound care and any other post-surgical care will be provided.
Alternatives
- Continuing antibiotics beyond 24 hours in cases where it is clinically indicated.
- Using other methods to prevent infections, such as advanced wound care or using different prophylactic measures.
- Each alternative has its own set of pros and cons which should be discussed with the healthcare provider.
Patient Experience
- Patients are unlikely to feel any immediate differences upon discontinuation of antibiotics.
- Medication for pain management and comfort is provided as necessary.
- Patients should report any unusual symptoms or signs of infection to their healthcare provider promptly.