spread of nasal MRSA without contributing to antibiotic resistance,
which is nothing to sneeze at.
Research shows that one-third of the general population is colo-
nized with nasal Staphylococcus aureus, and that 80% of surgical site
infections are caused by bacteria that originates in the nose.
"Nasal decolonization is a simple, low-cost way to help reduce infec-
tion risk, and patients seem to understand and not mind at all," says
Teresa M. Salley, RN, MS, MSN, perioperative manager at Sycamore
Hospital in Miamisburg, Ohio.
We reached out to OR managers who've made nasal antisepsis a
part of their SSI prevention bundle for pointers on doing so success-
fully. Here's what they had to say.
1. Should you decolonize all patients?
Some experts believe
you should swab all patients with a skin incision; others say it's better
to reserve nasal antisepsis for select patients undergoing procedures
with higher risks of infection.
One facility swabs a list of patients provided by infection preven-
tion, including all spine, joint replacement, transplant and bowel
patients. Another only decolonizes those patients who screen positive
for MRSA or MSSA.
"Anyone receiving an implant," is the criteria for Maureen May, RN,
BSN, director of surgical services at Ascension St. Vincent Carmel and
Fishers in Indiana. Nasal swabbing is reserved for joint, heart and
spine patients at Advocate Good Shepherd Hospital in Barrington, Ill.,
says perioperative educator Sharon Dillon, BSN, MPA, CNOR.
Houston Methodist Hospital in Baytown, Texas, will begin using nasal
sanitizing swabs on joint replacement patients in response to a recent
spate of MRSA infections, says clinical resource nurse Kathleen
Vandenbout, BSN, RN, BC, CAPA.
Others say you should make nasal swabbing a universal procedure.
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