povidone-iodine, they also screen every surgical patient ahead of time
for MRSA. This way, there's ample time to get the 10% or so of
patients who are carriers the right antibiotic. Patients who bypass the
pre-op holding area are treated with PI in the OR by the circulating
RN. So why screen and treat every patient with PI? Because, as Ms.
Schmidt explains, PI is effective against all gram-positive cocci in
addition to MRSA.
A word of caution: Ms. Schmidt says you can expect some early
pushback from nurses who don't see the value in adding 2 minutes to
patient check-ins. Keep them engaged by updating them quarterly
about the outcomes of their interventions. "People do things that have
value," she says. "Communicate that value. We're preventing SSIs."
To ensure a smooth liftoff, ask your vendor to send a trainer on site
for the first few days, says Ms. Schmidt, who was happy to also receive
templates for education. Finally, VA nurses don't swab themselves.
"Research has not shown that decolonizing staff makes a difference, so
we don't," she says.
The VA hasn't reported a MRSA SSI since the implementation of the
intervention. "On any given day, you can walk into the pre-op holding
area and hear the staff explaining and performing the intervention,"
says Ms. Schmidt. "I feel very accomplished that chart reviews reveals
high compliance, and the intervention has been adopted by the staff as
normal practice."
Alcohol based
Alcohol-based antiseptic treatments have a strong following. Among
alcohol's benefits: it doesn't contribute to bacterial resistance, its
effect is immediate and long-lasting, and, like iodine, it can be applied
immediately before surgery.
Then there's ease of use. Alcohol-based products dry quickly and are
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