Call for Algorithms: MRSA surveillance and pre-op antibiotics in cardiac and orthopedic surgery

I'm involved in an AHRQ-funded contract to identify and then study algorithms for SSI prevention in cardiac and orthopedic surgery. In an effort to expand our search for what methods others are using to prevent resistant Gram-positive SSIs, they asked that I post the call for algorithms here.  Our hope is that IPs or hospital epidemiologists could quickly send us their protocols. This study involves University of Iowa, The Joint Commission, AHRQ, and University of Maryland.  Thanks for your help!

Submit your hospital’s pre-operative algorithms and protocols for antimicrobial prophylaxis for patients with resistant Gram-positive organisms undergoing orthopedic and cardiac procedures

We are seeking examples of algorithms, protocols, pathways, policies and procedures, and standing orders that address selection and administration of antimicrobial prophylaxis for cardiac and orthopedic surgery patients. If your organization routinely screens pre-operative patients for MRSA, it would be helpful to also include screening and de-colonization algorithms and protocols.

The goal of this activity is to develop consensus-based algorithms for widespread dissemination that will contribute to reducing the rate of surgical site infections. This collaborative project, funded by the Agency for Healthcare Research and Quality (AHRQ), is being implemented by the University of Iowa, the University of Maryland, and The Joint Commission, with guidance from an expert panel of surgeons, anesthesiologists, and epidemiologists.

Please submit the information by fax or email to: Michele Bozikis at (630) 792-4922; mbozikis@jointcommission.org

Project Goals and Objectives
The goal of this project, "Optimizing Pre-Operative Antibiotic Prophylaxis for Cardiac and Orthopedic Procedures," is to determine whether a pre-operative antibiotic prophylaxis algorithm that includes the use (including selective use) of antibiotics shown to be effective against resistant gram-positive organisms is effective in reducing the number of surgical site infections (SSIs) attributable to resistant gram-positive organisms.

The objectives include:
1. Identify, through a review of the literature and existing studies, the most promising algorithms for pre-operative antibiotic prophylaxis for the prevention of SSIs in certain cardiac and orthopedic procedures
2. Develop one or more algorithms that incorporate the use (including selective use) of antibiotics shown to be effective against resistant gram-positive organisms
3. Design and conduct a study that compares the new algorithm(s) against standard algorithm(s) used for administering pre-operative antibiotic prophylaxis of SSIs in certain cardiac and orthopedic procedures

Future Opportunities
If additional funding is received, we will begin recruiting hospitals for participation in a study to test the effectiveness of the consensus-based algorithms at reducing SSIs. Recruitment will begin in Fall- 2011. Information will be shared as it becomes available. Stay tuned

For More Information
If you have questions about this project, please call Michele Bozikis at (630) 792-5922 or Joanne Hafner at (630) 792-5970; jhafner@jointcommission.org