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Does not apply to this measure
This measure is used to assess the percentage of surgical patients who received prophylactic antibiotics consistent with current guidelines (specific to each type of surgical procedure).
A goal of prophylaxis with antibiotics is to use an agent that is safe, cost-effective, and has a spectrum of action that covers most of the probable intraoperative contaminants for the operation. First- or second-generation cephalosporins satisfy these criteria for most operations, although quinolones are recommended for some urologic operations. Vancomycin is not recommended for routine use because of the potential for development of antibiotic resistance, but is acceptable if a patient is allergic to beta-lactams, as are fluoroquinolones and clindamycin in selected situations.
Surgery; prophylactic antibiotics
All selected surgical patients 18 years and older with no evidence of prior infection (see the related "Denominator Inclusions/Exclusions" field)
All selected surgical patients who received prophylactic antibiotics recommended for their specific operation*
*Refer to the original measure documentation for "Prophylactic Antibiotic Regimen Selection for Surgery."
A clinical practice guideline or other peer-reviewed synthesis of the clinical evidence
One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal
Use of this measure to improve performance
Variation in quality for the performance measured
|American Society of Health-System Pharmacists. ASHP therapeutic guidelines on antimicrobial prophylaxis in surgery. American Society of Health-System Pharmacists. Am J Health Syst Pharm. 1999 Sep 15;56(18):1839-88. [559 references] PubMed|
|Antimicrobial prophylaxis for surgery. Treat Guidel Med Lett. 2006 Dec;4(52):83-8. [42 references] PubMed|
|Bratzler DW, Houck PM, Surgical Infection Prevention Guidelines Writers Workgroup, American Academy of Orthopaedic Surgeons, American Association of Critical Care Nurses, American Association of Nurse Anesthetists, American College of Surgeons, American College of Osteopathic Surgeons, American Geriatrics Society, American Society of Anesthesiologists, American Society of Colon and Rectal Surgeons, American Society of Health-System Pharmacists, American Society of PeriAnesthesia Nurses, Ascension Health, Association of periOperative Registered Nurses, Association for Professionals in Infection Control and Epidemiology, Infectious Diseases Society of America, Medical Letter, Premier, Society for Healthcare Epidemiology of America, Society of Thoracic Surgeons, Surgical Infection Society. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis. 2004 Jun 15;38(12):1706-15. [90 references] PubMed|
|Dellinger EP, Gross PA, Barrett TL, Krause PJ, Martone WJ, McGowan JE Jr, Sweet RL, Wenzel RP. Quality standard for antimicrobial prophylaxis in surgical procedures. Infectious Diseases Society of America. Clin Infect Dis. 1994 Mar;18(3):422-7. [49 references] PubMed|
|Gilbert DN, Moellering RC Jr, Eliopoulos GM, Sande MA, editor(s). The Sanford guide to antimicrobial therapy. 37th ed. Hyde Park (VT): Antimicribial Therapy, Inc.; 2007. 160-1 p.|
|Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR, Hospital Infection Control Practices Advisory Committee. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1999 Apr;20(4):250-78; quiz 279-80. [497 references] PubMed|
|Page CP, Bohnen JM, Fletcher JR, McManus AT, Solomkin JS, Wittmann DH. Antimicrobial prophylaxis for surgical wounds. Guidelines for clinical care. Arch Surg. 1993 Jan;128(1):79-88. PubMed|
|Wolf JS Jr, Bennett CJ, Dmochowski RR, Hollenbeck BK, Pearle MS, Schaeffer AJ, Urologic Surgery Antimicrobial Prophylaxis Best Practice Policy Panel. Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol. 2008 Apr;179(4):1379-90. PubMed|
Current routine use
Internal quality improvement
Measure is not provider specific
Single Health Care Delivery Organizations
Age greater than or equal to 18 years
Either male or female
|Centers for Medicare & Medicaid Services (CMS). Specifications manual for hospital outpatient department quality measures (v 2.1a). Baltimore (MD): Centers for Medicare & Medicaid Services (CMS); 2009. 245 p.|
Users of care only
All selected surgical patients 18 years and older with no evidence of prior infection
Patients associated with provider
Patients with a CPT® Code of selected surgeries as defined in Appendix A, OP Table 6.0*
- Patients who are less than 18 years of age
- Patients whose procedure is canceled prior to incision as defined in the Data Dictionary*
- Patients enrolled in a Clinical Trial as defined in the Data Dictionary*
- Patients with an Infection Prior to Anesthesia as defined in the Data Dictionary*
- Patients who do not receive any antibiotics during the encounter
*Refer to the original measure documentation for details.
All cases in the denominator are equally eligible to appear in the numerator
Time window is a single point in time
Surgical patients who received prophylactic antibiotics recommended for their specific operation*
*Refer to the original measure documentation for "Prophylactic Antibiotic Regimen Selection for Surgery".
The measure results are somewhat or substantially under the control of the health care professionals, organizations and/or policymakers to whom the measure applies.
Encounter or point in time
Better quality is associated with a higher score
External comparison at a point in time
External comparison of time trends
Internal time comparison
OP-7: hospital outpatient surgery: prophylactic antibiotic selection for surgical patients.
Hospital Outpatient Department Quality Measures
Hospital Outpatient Surgery
Centers for Medicare & Medicaid Services
Centers for Medicare & Medicaid Services
United States Department of Health and Human Services
Centers for Medicare & Medicaid (CMS) Contractor
Measure was not adapted from another source.
This is the current release of the measure.
The individual measure, "OP-7: Hospital Outpatient Surgery: Prophylactic Antibiotic Selection for Surgical Patients," is published in the "Specifications Manual for Hospital Outpatient Department Quality Measures (Version 2.1a)." This document is available from the QualityNet Web site . Check the QualityNet Web site regularly for the most recent version of the specifications manual and for the applicable dates of discharge.
This NQMC summary was completed by ECRI Institute on February 20, 2009. The information was verified by the measure developer on May 8, 2009.
No copyright restrictions apply.
The Specifications Manual for Hospital Outpatient Department Quality Measures (Version 2.1a, January 2009) is periodically updated by the Centers for Medicare & Medicaid Services. Users of the Specifications Manual for Hospital Outpatient Department Quality Measures must update their software and associated documentation based on the published manual production timelines.
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