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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024QLL-126Improving the Percentage of Appropriate Chemoprophylaxis Duration in LowerSegment Caesarean Section Surgery (LSCS) Performed by Obstetrics andGynaecology Department Hospital MelakaSiow CC1, Nadzirah I1, Sarah Nazurah S1, Goh PN1, Syairah S1, Nursyuhaida MK1, Nuryuziliana D2, NorZaila Z3, Gan WF31Pharmacy Department, Hospital Melaka2 Obstetrics and Gynaecology (O&G) Department, Hospital Melaka3Infectious Disease Unit, Medical Department, Hospital MelakaSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Inappropriate surgical chemoprophylaxis duration will lead to antimicrobial resistance and increaseunnecessary treatment costs. From the surgical prophylaxis audit conducted in 2023, 97.8% of LSCSperformed in Hospital Melaka were prescribed with inappropriate chemoprophylaxis duration.KEY MEASURES FOR IMPROVEMENT:The indicator was the percentage of correct chemoprophylaxis duration in LSCS. Based on literaturefindings, the standard was set at %u226570%.PROCESS OF GATHERING INFORMATION:A cross-sectional study was conducted to determine the percentage of correct chemoprophylaxis durationin LSCS. Inclusion criteria was LSCS surgery performed in selected five working days, and exclusioncriteria were those patients who were already on antibiotics prior surgery or developed surgical siteinfection. Verification study was carried out in February 2023, while post remedial audit was carried outin March 2024. A short survey by questionnaire to the prescribers and pharmacists was conducted todetermine the contributing factors leading to high incidence of inappropriate surgical chemoprophylaxisduration in LSCS surgery.ANALYSIS AND INTERPRETATION:Verification study showed that only 2.2% of LSCS chemoprophylaxis was prescribed with correctduration. The most common causes of inappropriate chemoprophylaxis duration included unavailabilityof standardised protocol (26.3%), new or inexperienced staff (25.3%), and lack of awareness of correctpractice (24.2%).STRATEGIES FOR CHANGE:Total of four remedial measures were implemented from September 2023 to February 2024. A localprotocol on LSCS chemoprophylaxis Hospital Melaka was formulated, and the protocol was attached toevery drug chart in O&G wards as reference. It was also shared with all pharmacists so that they canintervene when receiving respective prescriptions which are not following guidelines. CME sessionregarding chemoprophylaxis was carried out in the O & G department.EFFECT OF CHANGE:We are able to improve the percentage of appropriateness of LSCS chemoprophylaxis duration from 2.2%to 55% post remedial measure implementation.THE NEXT STEP:Second cycle of survey and planning for other strategies is required to achieve the standard of 70%correct LSCS chemoprophylaxis duration in Hospital Melaka.218 | Page