Knowledge, attitude and practice of perioperative antibiotic prophylaxis among nurse-anaesthetists in Nigeria.

ABSTRACT

BACKGROUND: In Nigeria, nurse-anaesthetists are responsible for administering perioperative prophylactic antibiotics in a large number of operations but this practice is poorly studied. AIMS: The aim of this study was to evaluate the knowledge, attitude and practice of perioperative antibiotic prophylaxis among nurse-anaesthetists in Nigeria. METHODS: A cross-sectional study was conducted among nurse-anaesthetists at an Annual General Meeting/Scientific Conference of Nigeria Association of Nurse-Anaesthetists, using a pre-tested questionnaire. RESULTS: Of 70 questionnaires. 67 were returned. Antibiotic administration at induction of anaesthesia was considered inappropriate by 79.1% (n = 67) and safe by 42.6% (n = 61). There was poor knowledge of indications for intraoperative administration. There was agreement by 81.9% of respondents that anaesthetists should administer prophylactic antibiotics (n = 66) but 72.2% would want the surgeon to indicate the time of administration (n = 60). About 69.3% and 77.2% of respondents administered prophylactic antibiotics before tourniquet application (n = 62) and skin incision (n = 66) respectively in their practice but the latter finding was not corroborated by internal validity check. Availability of a hospital perioperative antibiotic prophylaxis protocol (p = 0.048) and practice for 10 or more years (p = 0.009) were associated with higher knowledge score. CONCLUSION: Inclusion of lectures on perioperative antibiotic prophylaxis in nurse-anaesthesia training curriculum, having hospital perioperative antibiotic prophylaxis protocol, stating in the protocols that surgeons give instructions on timing of antibiotic administration and ensuring adherence to the protocols may improve knowledge and practice of perioperative antibiotic prophylaxis among nurse-anaesthetists.