Imperial College London
Alternate

MrKrishnaMoorthy

Faculty of Medicine, Department of Surgery & Cancer

Clinical Senior Lecturer in Upper Gastrointestinal
 
 
 
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Contact

 

+44 (0)20 3312 7640k.moorthy

 
 
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Location

 

Academic Surgical Unit 10th FlooQueen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Charani:2017:10.1016/j.cmi.2017.03.013,
author = {Charani, E and Tarrant, C and Moorthy, K and Sevdalis, N and Brennan, L and Holmes, AH},
doi = {10.1016/j.cmi.2017.03.013},
journal = {Clinical Microbiology and Infection},
pages = {752--760},
title = {Understanding antibiotic decision making in surgery-a qualitative analysis.},
url = {http://dx.doi.org/10.1016/j.cmi.2017.03.013},
volume = {23},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVE: To investigate the characteristics and culture of antibiotic decision making in the surgical specialty. METHODS: A qualitative study including ethnographic observation and face-to-face interviews with participants from six surgical teams at a teaching hospital in London was conducted. Over a 3-month period: (a) 30 ward rounds (WRs) (100 h) were observed, (b) face-to-face follow-up interviews took place with 13 key informants, (c) multidisciplinary meetings on the management of surgical patients and daily practice on wards were observed. Applying these methods provided rich data for characterizing the antibiotic decision making in surgery and enabled cross-validation and triangulation of the findings. Data from the interview transcripts and the observational notes were coded and analysed iteratively until saturation was reached. RESULTS: The surgical team is in a state of constant flux with individuals having to adjust to the context in which they work. The demands placed on the team to be in the operating room, and to address the surgical needs of the patient mean that the responsibility for antibiotic decision making is uncoordinated and diffuse. Antibiotic decision making is considered by surgeons as a secondary task, commonly delegated to junior members of their team and occurs in the context of disjointed communication. CONCLUSION: There is lack of clarity around medical decision making for treating infections in surgical patients. The result is sub-optimal and uncoordinated antimicrobial management. Developing the role of a perioperative clinician may help to improve patient-level outcomes and optimize decision making.
AU  - Charani,E
AU  - Tarrant,C
AU  - Moorthy,K
AU  - Sevdalis,N
AU  - Brennan,L
AU  - Holmes,AH
DO  - 10.1016/j.cmi.2017.03.013
EP  - 760
PY  - 2017///
SN  - 1469-0691
SP  - 752
TI  - Understanding antibiotic decision making in surgery-a qualitative analysis.
T2  - Clinical Microbiology and Infection
UR  - http://dx.doi.org/10.1016/j.cmi.2017.03.013
UR  - http://hdl.handle.net/10044/1/46079
VL  - 23
ER  -
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