Table 3

Main findings from the study of surgical antibiotic prophylaxis (SAP) work processes in Norway, 2015-2016

ThemeProvision of SAP as a complex process of balancing timeliness by considering and responding to multiple interacting factors
SubthemeHandling SAP in consideration of multiple, preoperative interacting factorsTiming SAP administration in relation to knowledge and clinical experiencePerforming formal and informal checks
CategoryPerceptions of antibiotic prophylaxis work processes
(work as imagined)		Prescription accuracyDiverse prescription order systemsPatient-specific conditionsChanging schedules in operating theatreCognitive work task remindersImportance of knowledge and clinical experiencePerformance variety of Surgical Safety ChecklistIndirect and direct prescription validity checks
Codes

  • Roles

  • Responsibility

  • Location of performance

  • Time

  • Unclear prescriptions

  • Lack of prescriptions

  • Standardised prescription

  • Electronic default settings

  • Electronic, surgical planning system

  • Electronic medication chart

  • Paper-forms

  • Wall poster in operating theatre

  • Oral prescription

  • Pre-authorised prescription protocols

  • History of allergies

  • Type of surgery

  • Adjusting dosage in relation to age

  • Adjusting dosage in relation to weight (body mass index)

  • Order of scheduled patients

  • Deviations from scheduled patient order

  • Deviations from information in operating planning system

  • Timing of incision

  • Approximate time estimations

  • After patient transport

  • When positioning the patient

  • During placements of electrocardiography electrodes

  • When entering the operating theatre

  • After induction of anaesthesia

  • Local prescription systems

  • Surgeons’ preferences

  • Surgical procedures

  • Selection of antibiotics according to procedures

  • Alternative antibiotics

  • Interruption of workflow

  • Unclear responses of antibiotic item

  • Performance challenges

  • Responsibility

  • Identifies missed SAP administration

  • Paper documents

  • Electronic medication chart

  • Electronic surgical planning system

  • Prescribing signature

  • Calling surgeons

  • Paging surgeons

  • Approaching in person