Assessment of implementability of an adapted clinical practice guideline for surgical antimicrobial prophylaxis at a tertiary care university hospital

J Eval Clin Pract. 2017 Feb;23(1):156-164. doi: 10.1111/jep.12658. Epub 2016 Nov 3.

Abstract

Rationale, aims and objectives: Surgical site infections are the most common healthcare-associated infections. Appropriate surgical antimicrobial prophylaxis (SAP), which is an integral part of surgical site infection SSI prevention, is one of the major preventable risks to surgical patient safety. Several clinical practice guidelines (CPGs) for SAP have been published. The aim of this study was to adapt a CPG for SAP and to assess its implementability.

Methods: The methodology was based on two validated tools for CPGs, namely, the ADAPTE and the Guideline Implementability Appraisal (GLIA).

Results: The ADAPTE CPG adaptation process methodology was utilized to produce an adapted CPG for SAP based on the American Society of Health System Pharmacists 2013 CPG. The finalized CPG was then assessed to identify any possible intrinsic barriers for implementation.

Conclusions: In conclusion, the ADAPTE tool is a practical and successful tool for production of CPGs. The GLIA tool is useful for assessing and preparing the finalized adapted CPG for the transition from the production stage to the implementation stage. GLIA could be added to the ADAPTE process either as a final step or to check the draft of the CPG before finalization.

Keywords: ADAPTE; adaptation; clinical safety; evidence-based medicine; implementability.

MeSH terms

  • Antibiotic Prophylaxis / standards*
  • Evidence-Based Medicine
  • Hospitals, University / standards*
  • Humans
  • Practice Guidelines as Topic / standards*
  • Surgical Wound Infection / prevention & control*
  • Tertiary Healthcare