Stony Brook University Hospital Emergency Department

Stony Brook, New York

The Stony Brook University Hospital emergency department created a collaborative initiative between ED nurses and physicians, called Swift Need for Antibiotics Prophylaxis. The goal of SNAP is to administer antibiotics within 60 minutes of arrival for long-bone fractures. To promote early detection of open fractures, the ED triage nurse examines all fracture sites and initiates SNAP protocol if there is concern for an open fracture. When the SNAP protocol is initiated, the patient is immediately bedded in the ED. Prior to the Code SNAP initiative, 56 percent of long-bone fractures received antibiotics within 60 minutes of ED arrival. This collaborative SNAP initiative has helped the ED achieve the goal of having more than 90 percent of long- bone open fractures receiving antibiotics within 60 minutes of arrival to the ED. In the years after initiating SNAP, compliance has improved from 83 percent in 2021 to 91 percent in 2023. The SNAP protocol is still active and continues to be a collaborative effort between the ED nursing and physician teams. This is one of the many initiatives the 76-bed ED has implemented to unite nursing and physician teams toward excellent clinical outcomes.