Interventions
Monitoring the appropriateness of SPAs
The first intervention was the monitoring of SPA use and improving
its appropriateness. A multidisciplinary committee was
launched to improve the appropriateness of SPAs use in 2007 in accordance
with the inclusion of assessing the use of SPAs in national
hospital evaluation programs (NHEP) by the Health Insurance Review
and Assessment Service. Medical records of the patients who underwent
targeted surgeries in the designated months were reviewed
for the evaluation of performance indicators, which are timing of
antibiotic administration, appropriateness of the regimen, and duration
of SPAs. List of surgeries which were monitored and detailed
methods of monitoring are shown in the Supplementary Method.
Rates of adherence to the recommendations were measured regularly
in random samples, and feedback was given to surgical
departments. Lectures on the appropriate use of SPAs were provided
to the surgical staff and residents.