scholarly journals LO007: A pragmatic randomized and controlled evaluation of nurse-initiated protocols

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S32-S32
Author(s):  
M.J. Douma ◽  
D. O Dochartiagh ◽  
C.A. Drake ◽  
K.E. Smith
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Patient Flow ◽  
Intervention Group ◽  
Control Group ◽  
Emergency Nurses ◽  
Specific Patient ◽  
Patient Allocation ◽  
Ed Overcrowding ◽  
Controlled Evaluation

Introduction: Emergency department (ED) overcrowding is a common and complicated challenge for EDs worldwide. Nurse-initiated protocols, diagnostics and/or treatments implemented by nurses prior to patients being seen by a physician or nurse practitioner, have been suggested as a potential strategy to improve patient flow. Methods: This randomized, pragmatic, controlled evaluation of 5 nurse-initiated protocols occured in a crowded inner-city ED. Six physicians and 44 registered nurses, 3 clinical nurse educators and 3 unit managers were involved in revising 5 patient-complaint focused protocols prior to evaluation. Thirty (30/180) emergency nurses were provided 1 hour of training on inclusion and exclusion criteria, procedure and evaluation methods. Data was abstracted in a manner concealing patient allocation. Primary outcomes evaluated included time to diagnostic test, treatment, consultation or ED length of stay. This evaluation was completed following both the CONSORT and SQUIRE guidelines. Results: Time to acetaminophen for the intervention group (n=11) was 1h:04 min on average (95%CI 30min to 1h:37min) whereas the control group (n=9) was 3h:35min (95%CI 2h:21min to 4h:48min). The average length of stay of a suspected fractured-hip in the intervention group (n=5) was 3h:34min (95%CI 1h:49min to 5h:19min) and 7h:34min for the control group (n=4) was (95%CI 5h:26min to 9h:42min). Time to troponin in the intervention group (n=29) was one quarter (average 48min, 95% CI 32min to 64min) of the time it was in the control group (n=14) (average 3h:16min, 95%CI 1h:53min to 4h:39min; p < 0.001). The vaginal bleeding in pregnancy protocol reduced length of stay by roughly fifty-percent; the intervention group (n=11) had a length of stay of 4h:57min (95%CI 3h:46min to 6h:08min) compared to 8h:33min (95% CI 6h:23min to 10h:44min) for the control (n=7) (p < 0.001). There was no statistical difference in the length of stay for patients who received protocolized diagnostics for abdominal pain. Conclusion: Targeting specific patient groups with carefully written protocols can improve the timeliness of care. A cooperative and collaborative interdisciplinary group are essential to success. Having a system in place to ensure ongoing quality in protocol application and interdisciplinary support has proven more difficult than improving the primary outcomes in this evaluation.

scholarly journals INFLUENCE OF NURSING CLINICAL PATHWAY IMPLEMENTATION TO LENGTH OF STAY OF NON HEMORRHAGIC STROKE PATIENTS IN BUKITTINGGI ACHMAD MOCHTAR HOSPITAL

2018 ◽  
Vol 12 (1) ◽  
pp. 9
Author(s):  
Fitrianola Rezkiki
Keyword(s):  
Length Of Stay ◽  
Nursing Care ◽  
Clinical Pathway ◽  
Hemorrhagic Stroke ◽  
Average Length ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Stroke Patients ◽  
Nursing Clinical

<p><em>Lenght of stay is indicator of serving quality and nursing care to measure hospital efficiency level. Neurology ward is one of the wards that experience increasing of length of stay from 5,91 to 7,38. The cause of length of stay increasing is nursing care management that according to Calhoun can be formulated to nursing clinical pathway. The purpose of this study is to analyze influence of nursing clinical pathway implementation to length of stay of non hemorrhagic stroke patients in neurology ward Bukitttinggi Achmad Mochtar Hospital. The designs of this study used non-equivalent post test only control group design approach. Sample of this study were taken by purposive sampling with total of 32 samples consist of 16 sample as intervention group and another 16 samples as control group. Data analyzing used t-test independent. The result shows that there is significant influence for average length of stay of stroke non hemorrhagic patients that were given nursing clinical pathway compared to the group that is not given nursing clinical pathway with p value 0,001 (p value ≤ 0,05. According to this study, hospital should implement nursing clinical pathway when doing nursing care to patients in ward and also hospital should make policy related to nursing clinical payhway implementation..</em></p><p><em> </em></p>

Palliative medicine consultation impacts DNR designation and length of stay for terminal medical MICU patients

2011 ◽  
Vol 9 (4) ◽  
pp. 401-406 ◽  
Author(s):  
Dana Lustbader ◽  
Renee Pekmezaris ◽  
Michael Frankenthaler ◽  
Rajni Walia ◽  
Frederick Smith ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Palliative Medicine ◽  
Intervention Group ◽  
Hospital Length Of Stay ◽  
Rank Test ◽  
Control Group ◽  
Do Not Resuscitate ◽  
Log Rank Test ◽  
The Impact ◽  
Reduced Time

AbstractObjective:The purpose of this study was to assess the impact of a palliative medicine consultation on medical intensive care unit (MICU) and hospital length of stay, Do Not Resuscitate (DNR) designation, and location of death for MICU patients who died during hospitalization.Method:A comparison of two retrospective cohorts in a 17-bed MICU in a tertiary care university-affiliated hospital was conducted. Patients admitted to the MICU between January 1, 2003 and June 30, 2004 (N = 515) were compared to MICU patients who had had a palliative medicine consultation between January 1, 2005 and June 1, 2009 (N = 693). To control for disease severity, only patients in both cohorts who died during their hospitalization were considered for this study.Results:Palliative medicine consultation reduced time until death during the entire hospitalization (log-rank test,p < 0.01). Time from MICU admission until death was also reduced (log-rank test,p < 0.01), further demonstrating the impact of the palliative care consultation on the duration of dying for hospitalized patients. The intervention group contained a significantly higher percentage of patients with a DNR designation at death than did the control group (86% vs. 68%, χ2test,p < 0.0001).Significance of results:Palliative medicine consultation is associated with an increased rate of DNR designation and reduced time until death. Patients in the intervention group were also more likely to die outside the MICU as compared to controls in the usual care group.

scholarly journals Mental health history—a contributing factor for poorer outcomes in burn survivors

2018 ◽  
Vol 6 ◽  
Author(s):  
Frank Li ◽  
Danielle Coombs
Keyword(s):  
Mental Health ◽  
Length Of Stay ◽  
Average Length ◽  
Adult Population ◽  
Total Body Surface Area ◽  
Control Group ◽  
Health History ◽  
Health Group ◽  
Burn Survivors ◽  
Mental Health History

Abstract Background A pre-morbid mental health history is common in patients with severe burn injuries. This creates challenges in providing rehabilitation. The aim of this study is to cross examine the possible impact of psychological co-morbidities on outcomes. Methods A notes audit was carried out examining patients that were admitted to Concord Hospital Burns Unit in a 3-year period (2010–2012). Patients with total body surface area (TBSA) of 20% or greater and aged between 16 and 50 years were included. Subjects were divided into a mental health group and a control group. SPSS version 21 statistic program was used for analysis the data. Results Data collected included length of stay, time to achieve independence, %TBSA, types of burns and surgery required. Results of 69 files showed that the average length of stay per %TBSA was nearly double in the patients with a mental health problem (1.47 vs 0.88). They also had a higher rate of re-graft (52% vs 22%) due to infection and poor nutrition. The average time for patients to achieve independence in daily living activity was significantly higher (p = 0.046) in the mental health group (36.2 days) versus the control group (24.1 days). Conclusion Patients with a mental health history may have poorer general health. This may result in a higher failure rate of grafting, leading to a requirement of re-graft. Hence, it took a longer time to achieve independence, as well as a longer hospital stay. A mental health history in burn survivors can be a contributing factor for poorer outcomes in the adult population.

Improving Family Communications at the End of Life: Implications for Length of Stay in the Intensive Care Unit and Resource Use

2003 ◽  
Vol 12 (4) ◽  
pp. 317-324 ◽  
Author(s):  
Tom Ahrens ◽  
Valerie Yancey ◽  
Marin Kollef
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
End Of Life ◽  
Resource Utilization ◽  
Intervention Group ◽  
Clinical Nurse Specialist ◽  
Control Group ◽  
Nurse Specialist ◽  
Clinical Nurse

• Background Inadequate communication persists between healthcare professionals and patients and patients’ families in intensive care units. Unwanted or ineffective treatments can occur when patients’ goals of care are unknown or not honored, increasing costs and care. Having the primary physician provide medical information and then having a physician and clinical nurse specialist team improve opportunities for patients and their families to process that information could improve the situation. This model has not been tested for its effect on patients’ outcomes and resource utilization.• Objectives To evaluate the effect of a communication team that included a physician and a clinical nurse specialist on length of stay and costs for patients near the end of life in the intensive care unit.• Methods During a 1-year period, patients judged to be at high risk for death (N = 151) were divided into 2 groups: 43 patients who were cared for by the medical director teamed with a clinical nurse specialist and 108 patients who received standard care, provided by an attending physician.• Results Compared with the control group, patients in the intervention group had significantly shorter stays in both the intensive care unit (6.1 vs 9.5 days) and the hospital (11.3 vs 16.4 days) and had lower fixed ($15 559 vs $24 080) and variable ($5087 vs $8035) costs.• Conclusions Use of a physician and a clinical nurse specialist focused on improving communication with patients and patients’ families reduced lengths of stay and resource utilization.

scholarly journals The Sydney triage to admission risk tool (START) to improve patient flow in an emergency department: a model of care implementation pilot study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Anja Ebker-White ◽  
Kendall J. Bein ◽  
Saartje Berendsen Russell ◽  
Michael M. Dinh
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Patient Flow ◽  
Intervention Group ◽  
Control Sample ◽  
Patient Admission ◽  
Implementation Study ◽  
Model Of Care ◽  
Early Assessment ◽  
Pilot Implementation

Abstract Background The Sydney Triage to Admission Risk Tool (START) is a validated clinical analytics tool designed to estimate the probability of in-patient admission based on Emergency Department triage characteristics. Methods This was a single centre pilot implementation study using a matched case control sample of patients assessed at ED triage. Patients in the intervention group were identified at triage by the START tool as likely requiring in-patient admission and briefly assessed by an ED Consultant. Bed management were notified of these patients and their likely admitting team based on senior early assessment. Matched controls were identified on the same day of presentation if they were admitted to the same in-patient teams as patients in the intervention group and same START score category. Outcomes were ED length of stay and proportion of patients correctly classified as an in-patient admission by the START tool. Results One hundred and thirteen patients were assessed using the START-based model of care. When compared with matched control patients, this intervention model of care was associated with a significant reduction in ED length of stay [301 min (IQR 225–397) versus 423 min (IQR 297–587) p < 0.001] and proportion of patients meeting 4 h length of stay thresholds increased from 24 to 45% (p < 0.001). Conclusion In this small pilot implementation study, the START tool, when used in conjunction with senior early assessment was associated with a reduction in ED length of stay. Further controlled studies are now underway to further examine its utility across other ED settings.

scholarly journals The role of the psychologist in the inpatient pain service: development and initial outcomes

2020 ◽  
pp. 204946372092621
Author(s):  
Chandran Jepegnanam ◽  
Eleanor Bull ◽  
Sujesh Bansal ◽  
David McCarthy ◽  
Maureen Booth ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Length Of Stay ◽  
Hospital Admissions ◽  
Psychological Intervention ◽  
Intervention Group ◽  
Skills Training ◽  
Service Evaluation ◽  
Control Group ◽  
Psychological Interventions

Aim: This article describes the development and initial evaluation of introducing a psychologist role within an adult inpatient pain service (IPS) in a large North West of England National Health Service (NHS) trust. Background: The role of a psychologist in the management of outpatient chronic pain has been well documented, but their role within the IPS is less well described and rarely evaluated. We describe the development of a psychologist role within the team and initial service evaluation outcomes. Methods: Following an initial needs assessment, a band 8c psychologist joined the IPS one day per week offering brief one-to-one psychological interventions to people struggling with acute or chronic pain in hospital referred by inpatient pain team. The psychologist had an indirect role offering training, supervision and support to members of the inpatient pain team. Regarding direct patient work, following psychometric screening for pain-related disability and distress, a cognitive behavioural therapy (CBT) approach was applied including identifying unhelpful beliefs about pain, psychoeducation about acute and persistent pain, developing and sharing formulations, skills training including breathing and relaxation exercises and where appropriate, signposting onto an outpatient chronic pain services for further pain self-management advice (e.g. pain management programme. To explore the impact of this direct intervention, a prospective service evaluation with a controlled before and after design was conducted. This compared (a) number of admissions and (b) length-of-stay outcomes in the 12 months following psychometric screening for patients who received psychological input (n = 34, the treatment group) and a sample who did not receive input because of discharge before intervention or non-availability of the psychologist, for example, annual leave (n = 30, control group). Demographic information and summaries of psychometric questionnaires were also analysed. Results: Of the sample of 64 patients, 50 were women, ages ranged from 18–80 years, 72% reported being currently unemployed or off sick from work and on screening and 39% and 48% met criteria for severe depression and pain-related anxiety, respectively. Hospital admissions in the intervention group reduced significantly (by 60%) in the 12 months following screening but increased (by 7%) for the control group (F(1,62) = 7.21, p = .009). Days of stay in hospital reduced significantly more (by 84%) in the intervention group than in the control group (by 41%) (F(1,62) = 8.90, p = .004). Illustrated case studies of brief psychological intervention with three people struggling with pain-related distress are presented. Conclusions: The psychologist became a valuable member of the multi-disciplinary IPS team, offering brief direct and indirect psychological interventions. While a relatively small sample, our prospective service evaluation data suggest brief psychological intervention may contribute to reduced length of stay and hospital admissions for people experiencing pain-related distress in hospital.

Early rehabilitation after hospital admission for road trauma using an in-reach multidisciplinary team: a randomised controlled trial

2017 ◽  
Vol 31 (9) ◽  
pp. 1189-1200 ◽  
Author(s):  
Jane Wu ◽  
Steven G Faux ◽  
John Estell ◽  
Stephen Wilson ◽  
Ian Harris ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Usual Care ◽  
Intervention Group ◽  
Psychological Status ◽  
Randomised Control Trial ◽  
Control Group ◽  
Rehabilitation Team ◽  
Secondary Outcomes ◽  
The Impact

Objective: To investigate the impact of an in-reach rehabilitation team for patients admitted after road trauma. Design: Randomised control trial of usual care versus early involvement of in-reach rehabilitation team. Telephone follow-up was conducted by a blind assessor at three months for those with minor/moderate injuries and six months for serious/severe injuries. Setting: Four participating trauma services in New South Wales, Australia. Subjects: A total of 214 patients admitted during 2012-2015 with a length of stay of at least five days. Intervention: Provision of rehabilitation services in parallel with ward based therapy using an in-reach team for the intervention group. The control group could still access the ward based therapy (usual care). Main measures: The primary outcome was acute length of stay. Secondary outcomes included percentage requiring inpatient rehabilitation, function (Functional Independence Measure and Timed Up and Go Test), psychological status (Depression Anxiety and Stress Score 21), pain (Orebro Musculoskeletal Pain Questionnaire) and quality of life (Short Form-12 v2). Results: Median length of stay in acute care was 13 days (IQR 8-21). The intervention group, compared to the control group, received more physiotherapy and occupational therapy sessions (median number of sessions 16.0 versus 11.5, P=0.003). However, acute length of stay did not differ between the intervention and control groups (median 15 vs 12 days, P=0.37). There were no significant differences observed in the secondary outcomes at hospital discharge and follow-up. Conclusion: No additional benefit was found from the routine use of acute rehabilitation teams for trauma patients over and above usual care.

scholarly journals Tactile-kinesthetic stimulation to gain weight and reduce the length of stay care for premature baby at public hospitals of Semarang, Indonesia

2019 ◽  
Vol 3 (1) ◽  
pp. 25
Author(s):  
Freya Nazera Iskandar ◽  
Ari Suwondo ◽  
Bedjo Santoso
Keyword(s):  
Birth Weight ◽  
Length Of Stay ◽  
Low Birth Weight ◽  
Intervention Group ◽  
Premature Baby ◽  
Kangaroo Mother Care ◽  
Public Hospitals ◽  
Control Group ◽  
Hospital Unit ◽  
Premature Babies

Background: Premature babies are susceptible to a variety of health problems in early of their lives, thus, management of premature care should be designed to optimize the growth and development, with no more cost extension. The management of premature care by non-pharmacological treatments becomes popular nowadays, and applied in the hospital unit care, including the Tactile-Kinesthetic Stimulation (TKS) and Kangaroo Mother Care (KMC).Aims: This study is to present the effect of Tactile-Kinesthetic Stimulation (TKS) on weight gain and reduction length of stay care for premature babies, and to compare the results with the standard Kangaroo Mother Care (KMC) given at the hospital care unit.Methods: The study used a quasi-experimental design with pretest-posttest with a control group. A total of 32 premature babies was equally divided to a control group given a standard KMC procedure and an intervention group receiving the TKS. Sampling was done using a consecutive sampling method where the low birth weight infants were selected from two public hospitals in Semarang of Indonesia, with consent from the parents. Data was then analyzed by a repeated measure ANOVA, general linear model and Mann-Whitney test to find the significant mean difference at p value less than 0.05.Results: The data shows that the babies’ weight significantly increased day by day only if the premature neonates received Tactile-Kinesthetic Stimulation, gained 148.75 gram only 3 days after the initial measurement. However, from this study we noted that the premature babies’ weight at the control group provided only with Kangaroo Mother Care slightly decreased at 35.69 gram at the third day of observation. In average, premature babies receiving TKS need only 3 days before return home, while if receiving the standard KMC the preterm babies required 5 days in the hospital care.Conclusion: Not only effective to gain the weight, giving Tactile-Kinesthetic Stimulation to the low birth weight baby shorter the length of stay in the hospital unit care. It suggests that the TKS intervention will provide good result in maintaining the weight of the low birth weight baby and will reduce the costs of staying in the hospital unit care. Keywords: Tactile-Kinesthetic Stimulation, Kangaroo Mother Care, Low birth weight, Length of stay care, Premature baby.

scholarly journals Steroid use for recovery of advanced atrioventricular block immediately after valvular surgery (survival): a randomized clinical trial

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
F Masoudkabir ◽  
S Ghodsi ◽  
Z Hosseini ◽  
T Davarpasand ◽  
A Haj Hossein Talasaz ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Atrioventricular Block ◽  
Recovery Rate ◽  
Heart Surgery ◽  
Intervention Group ◽  
Implantation Rate ◽  
Control Group ◽  
High Dose ◽  
Valvular Surgery ◽  
And Control

Abstract Funding Acknowledgements Type of funding sources: None. Background Limited inconsistent evidence support use of steroids in recovery of atrioventricular block (AVB) after trans-catheter aortic valve implantation. However, there is no study to examine the efficacy of steroids in recovery of high-grade AVB following valvular surgery. Purpose  To assess the effect of high-dose dexamethasone on recovery of advanced AVB following valvular heart surgery. Methods In this randomized controlled trial, patients with advanced postoperative AVB (either Mobitz type II or third degree) were randomly assigned to receive either dexamethasone (0.4 mg /kg, maximum 30 mg /day in three divided doses) intravenously for three days or conservative care only. Primary endpoint was recovery rate in day five since randomization. Secondary endpoints were recovery rate in day 7 and day 10, cumulative AVB time, PPM implantation rate, length of stay in critical care units, and post-operative major adverse events (MAE) during one month. We defined MAE as composite of all-cause mortality, all-type infections, major bleeding, prolonged sternal dehiscence, new stroke, postoperative MI, complicated uncontrolled hyperglycemia and readmission for decompensated heart failure. Results We enrolled 139 subjects (48.9% male) with mean age of 59.9 years who were randomly allocated to intervention group (n= 69) and control group (n= 70). Dexamethasone led to higher recovery rates at day 5 (82.6% vs. 62.9%, P= 0.009) and day 7 (88.4% vs. 61.4%, P&lt; 0.0001) respectively. Random 24-hours ECG Holter monitoring of patients at day 5 revealed the same results and confirmed the superiority of dexamethasone for recovery of AVB (80.5% vs 61.2%, respectively, P = 0.024). Although this benefit ceased at day 10 (83.05 vs 78.6 %, P = 0.547), Generalized Estimating Equation analysis for recovery over 10 days favored intervention (odds ratio: 2.56, 95% CI: 1.27- 5.15, P = 0.008). Median cumulative AVB time was shorter in dexamethasone group compared to control group (41 hours vs 64 hours, P = 0.044). PPM implantation rates were similar between the dexamethasone and control groups (15.9% vs 17.1 %, respectively, P = 0.849). Median length of stay in ICU (10 days vs 12 days, P= 0.03) and MAE (17.4 % vs 25.7%, P = 0.133) tended to be lower with dexamethasone. Conclusion Our findings suggest that dexamethasone may serve as a safe and effective medication to improve recovery of advanced AVB after valvular surgery. Further studies are needed to confirm these findings, particularly regarding subsequent PPM implantation rate.

scholarly journals PERBANDINGAN ANTARA PEMBERIAN ANTIBIOTIKA PROFILAKSIS PADA SEKSIO SESAR SESUAI ALUR KLINIS RSUP DR SARDJITO DENGAN ANTIBIOTIKA DOSIS MULTIPEL TERHADAP KEJADIAN INFEKSI LUKA OPERASI

2016 ◽  
Vol 3 (2) ◽  
pp. 75
Author(s):  
Ardian Rahmansyah ◽  
Mohammad Hakimi ◽  
Rukmono Siswishanto
Keyword(s):  
Length Of Stay ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Clinical Pathway ◽  
Intervention Group ◽  
Group Versus ◽  
Control Group ◽  
Site Infection ◽  
Short Term

Background: Clinical pathway recommend the use of short-term prophylaxis antibiotics for cesarean section. Long-term antibiotics or multiple doses was found in clinical practice. There are differences in the mode of administration and the number of doses administered at sardjito hospital.Objective: To determine the effectiveness of short-term antibiotic prophylaxis in cesarean section appropriate to clinical pathway in the prevention of surgical site infection (ssi), the incidence of fever, dysuria events, length of stay.Method: The study used randomized clinical trial. The study subjects who underwent cesarean section and meet the inclusion and exclusion criteria in the period July 2013 to January 2014 divided into an intervention group (n = 52) who received ampicillin 2 gram pre and post-cesarean section, and a control group (n = 54) who received ampicillin 2 gram pre cesarean section and 1 gram every 8 hours for 6 times. Observed on days 3 and 10 post-cesarean section. The primary outcomes assessed were the incidence of surgical wound infection based on the criteria of surgical site infection from Centers for Disease Controland Prevention. Secondary outcomes assessed were the incidence of fever, dysuria events, length of stay. Homogeneity analysis were conducted on subject. Outcome analysis performed bivariate with t test and chi squared test.Results and Discussion : A total of 106 subjects can be analyzed. SSI events in the intervention group at day 3 was 3.8% (n = 52) and control group was 1.84% (n = 54) with p>0.05 RR 2.077 (95% CI 0.194 to 22.219). SSI on day 10 of 7.7% (n = 52) in the intervention group versus 9.3% (n = 54) in controls with p<0.05 RR 0.831 (CI 95%, 0.236 to 2.924). Fever events on day 3 by 5.8% in the intervention group versus 3.7% incontrols with p>0.05 RR 1.558 (95% CI 0.271 to 8.948) and on day 10 was 3.8% versus 3.7 % with p>0.05 RR 1.038 (95% CI 0.152 to 7.102). Dysuria not found on day 3 and but on 10 found 5.8% in the intervention group versus 11.1% with p>0.05 RR 0.519 (IK95% 0.137 to 1.968). Length of stay after cesarean section for 3.21 ± 0.412 days in the intervention group and 3.26 ± 0.442 days in the control group with p>0.05 (95% CI -0.213 - 0.117).Conclusion: There is no significant difference in the incidence of surgical wound infections, the incidence of fever, dysuria, length of stay between short-term prophylaxis antibiotics ampicillin appropriate to clinical pathway and long-term or multiple doses prophylaxis antibiotics. Short term antibiotics prophylaxis are more efficiently with the same effectiveness in preventing outcomes research.Keywords: prophylaxis antibiotics, ampicillin, short term regimen, long term regimen, cesarean section, surgical site infection. 

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