Practices of injectable antibiotics preparation and administration among healthcare practitioners in multidisciplinary wards

Injectable antibiotics with rapid deliveries to infection sites are preferable in healthcare settings. Low incidence of appropriate injectable antibiotics preparation and administration (IAPAA) among healthcare practitioners will cause antimicrobial resistance, thrombophlebitis, and mortality. This study aimed to identify rates of appropriate IAPAA, possible contributing factors, implement strategies, and evaluate their effectiveness.A cross-sectional study involving direct observation was conducted in Hospital Tanjung Karang (HTK) multidisciplinary wards from August 2018 to February 2019. 148 samples fulfilling criteria were randomly selected. Data collection form was used to record demographic profiles from bed-head-ticket (BHT) and observed IAPAA processes. Rates of appropriate IAPAA were determined and analyzed with SPSS Statistics. Descriptive statistics were employed. The rate of appropriate IAPAA upon verification was only 14.2%. All uncommon and slow intravenous (SIV) antibiotics demonstrated 0% appropriateness. Possible factors included unaware of rare procedures, inadequate references, knowledge, and monitoring. The rate was successfully improved to 49.3% after various implementations, including "SWeFT." Among all six IAPAA categories, reconstitution concentration and administration duration revealed the most improvements, from 33.8% to 93.8% and 18.9% to 52.7%. Staff nurses found antibiotics rarely initiated by visiting specialists less familiar. The least appropriate administration duration was mostly come from SIV antibiotics, whereby inadequate equipment and personal problems were the possible reasons. Inappropriate IAPAA practices are preventable with proper measures. Further innovations or inward patient care systems, containing electronic BHT and nursing injections preparation and administration alert systems, should be implemented to improve clinical outcomes and safety of patients.