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least a week before surgery for traces of S. aureus. We give patients
who test positive an ointment to apply for 5 days before surgery to
clear out the bacteria. We also encourage patients with signs of S.
aureus to prepare their skin with chlorhexidine gluconate wipes or
soap for 5 days before surgery. But because the pre-op washes and
wipes are inexpensive and easy to use, we also ask non-carriers to
apply CHG the night before and morning of surgery.
We also encourage the appropriate use of pre-op antibiotics.
Patients who carry methicillin-resistant S. aureus (MRSA) receive
vancomycin — because it's active against MRSA — in addition to the
standard dose of cefazolin. The timing of vancomycin administration
is important; it takes a while to become active in the bloodstream, so
have a system in place between the OR and pre-op to ensure the drip
starts about an hour before surgery begins.
I N F E C T I O N C O N T R O L
In the real-world reality of running of a
surgical facility, decisions to improve patient
care have to make good business sense.
Pamela
Bevelhymer,
RN,
BSN
