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03/27/19 LW -- Post-OP Antibiotics

From: Logan Whitfield
Sent: Wednesday, March 27, 2019 8:25:22 AM
Subject: Post-OP Antibiotics

Attachment: OR Intraop record- General case data

Good Morning Everyone,

As you all have noticed with Cerner implementation there are no longer "stickers" indicating the surgery class (e.g. clean-contaminated versus dirty) on post-op order sets. I am now attempting to address surgical post-op Powerplans that have orders for post-op antibiotics inappropriately. This will take time to go through committee. For now, when verifying medication orders post-op, there will be documentation of the wound class within the "OR Intraoperative Record" under Documentation in PowerChart. As prior to Cerner implementation, we are to automatically discontinue all post-op antibiotic orders of cefazolin, clindamycin, or vancomycin for clean/clean-contaminated procedures with the following exceptions:

a.        Post-op orders with 'until drain removed' in neurosurgery patients
b.        For CV surgery post-op orders ≤ 48 hours
c.        Joint replacement post-op orders ≤ 24 hours
d.        Colorectal surgery post-op orders
e.        Post-op orders for Implantation of spinal cord stimulator, generator, and lead wires ≤ 24 hours

Attached is a document that shows where the wound class may be found. Please do not hesitate to call me or Jonathan Edwards with any questions.

Thank You,

Philip Logan Whitfield, PharmD
PGY2 Infectious Disease Pharmacy Resident