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Prophylactic Antibiotics Discontinued Within 24 Hours After Surgery End Time

CBE ID
0529
1.4 Project
Surgery Endorsement
Endorsement Status
Endorsed with Reserve Status
Previous Endorsement Cycle
Full Year 2013
Is Under Review
No
1.3 Measure Description

Surgical patients whose prophylactic antibiotics were discontinued within 24 hours after Anesthesia End Time. The Society of Thoracic Surgeons (STS) Practice Guideline for Antibiotic Prophylaxis in Cardiac Surgery (2006) indicates that there is no reason to extend antibiotics beyond 48 hours for cardiac surgery and very explicitly states that antibiotics should not be extended beyond 48 hours even with tubes and drains in place for cardiac surgery.

    • 1.14 Numerator

      Number of surgical patients whose prophylactic antibiotics were discontinued within 24 hours after Anesthesia End Time (48 hours for CABG or Other Cardiac Surgery).

    • 1.15 Denominator

      All selected surgical patients with no evidence of prior infection.
      Included Populations:
      • An ICD-9-CM Principal Procedure Code of selected surgeries (as defined in Appendix A, Table 5.10 for ICD-9-CM codes)
      AND
      • An ICD-9-CM Principal Procedure Code of selected surgeries (as defined in Appendix A, Table 5.01-5.08 for ICD-9-CM codes)

    • Exclusions

      Excluded Populations:
      • Patients less than 18 years of age
      • Patients who have a Length of Stay greater than 120 days
      • Patients whose Principal Procedure was on Table 5.25
      • Patients who had a principal diagnosis suggestive of preoperative infectious diseases (as defined in Appendix A, Table 5.09 for ICD-9-CM codes)
      • Patients enrolled in clinical trials
      • Patients whose ICD-9-CM principal procedure occurred prior to the date of admission
      • Patients with physician/advanced practice nurse/physician assistant (physician/APN/PA) documented infection prior to surgical procedure of interest
      • Patients who expired perioperatively
      • Patients who had other procedures requiring general or spinal anesthesia that occurred within three days (four days for CABG or Other Cardiac Surgery) prior to or after the procedure of interest (during separate surgical episodes) during this hospital stay
      • Patients who received urinary antiseptics only (as defined in Appendix C, Table 3.11)
      • Patients with Reasons to Extend Antibiotics
      • Patients who received antibiotics prior to arrival and did not receive any antibiotics during this hospitalization
      • Patients who received ONLY antibiotics with the route unable to be determined (UTD)
      • Patients who did not receive any antibiotics within the timeframe 24 hours before Surgical Incision Date and Time (i.e., patient did not receive prophylactic antibiotics) through discharge
      • Patients who received ALL antibiotics greater than 1440 minutes prior to Surgical Incision Date and Time
      • Patients who received ALL antibiotics greater than 3 days after Anesthesia End Date OR greater than 2 days after Anesthesia End Date for Principal Procedures on Tables 5.03-5.08
      • Patients who received ALL antibiotics greater than 4320 minutes after Anesthesia End Time OR greater than 2880 minutes after Anesthesia End Time for Principal Procedures on Tables 5.03-5.08

    • Most Recent Endorsement Activity
      Endorsed with Reserve Status Surgery Endorsement Project 2013-2015
      Initial Endorsement
      Last Updated
    • Steward
      Centers for Medicare & Medicaid Services
      Steward Organization POC Email
      [email protected]
      Steward Organization Copyright

      N/A