Implementing a policy for pneumococcal prophylaxis in a haematology unit after splenectomy
| Autor: | B A Perry, M J Leyland, A G Smith, S G Long, D W Milligan |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
medicine.medical_specialty
Pediatrics Leadership and Management medicine.drug_class medicine.medical_treatment Antibiotics Splenectomy Pneumococcal Infections Sepsis Postoperative Complications Internal medicine London Humans Medicine Antibiotic prophylaxis Intensive care medicine General Nursing Hematology business.industry Health Policy Incidence (epidemiology) Public Health Environmental and Occupational Health Antibiotic Prophylaxis medicine.disease Organizational Policy Bacterial vaccine Pneumococcal infections Bacterial Vaccines Practice Guidelines as Topic Disease Susceptibility business Hospital Units Research Article |
| Zdroj: | Quality and Safety in Health Care. 4:194-196 |
| ISSN: | 1475-3901 1475-3898 |
| DOI: | 10.1136/qshc.4.3.194 |
| Popis: | People who have had a splenectomy for any reason are 40 times more likely to have an overwhelming infection, especially pneumococcal infection, and 17 times more likely to suffer fatal sepsis. The incidence of such life threatening infections is reduced by prophylactic immunisation with polyvalent pneumococcal vaccine and long term antibiotic prophylaxis or instituting prompt antibiotic treatment in the event of fever. This haematology unit agreed a policy of immunisation and antibiotic prophylaxis in June 1988 for all patients undergoing elective splenectomy. The success of this policy was audited in July 1993 by a retrospective analysis of patients' case notes. Seventy four patients were identified as having had a splenectomy, 54 (73%) before June 1988, of whom only 13 (24%) had received both pneumococcal immunisation and antibiotic prophylaxis before implementation of the agreed policy. At the time of audit, 46/74 (62%) patients were recorded as having received immunisation and 64/74 (86%) as receiving antibiotic prophylaxis or a supply of antibiotics to take in the event of a fever. All but one of the 20 patients who had a splenectomy after June 1988, since implementation of the agreed policy, received immunisation and antibiotic prophylaxis. The authors conclude that establishment of a formal agreed policy for pneumococcal prophylaxis for patients undergoing splenectomy has improved the quality of care. |
| Databáze: | OpenAIRE |
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