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O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | M A Y 2 0 1 5
No Mercy for MRSA
Our new protocol has all but stamped out this superbug.
A
s a high-volume ortho-
pedic facility that uses
implants in almost
every case, we're especially con-
cerned about surgical site infec-
tions. Two-plus years ago, we set
out to reduce MSSA (methicillin-
sensitive Staphylococcus aureus)
and MRSA (methicillin-resistant
S. aureus) infections, and our
efforts are paying off. Here are the key elements to our protocol:
• Universal screening. We proactively screen all patients for MRSA
with nasal swabs within 30 days of their scheduled procedure. One of
the benefits of universal screening is that there's never a question as
to who gets screened and who doesn't.
• If a patient tests positive ... We educate and treat all patients who test
positive. We give patients who test positive 5-day supplies of both
mupirocin in nasal vestibules and chlorhexidine gluconate (CHG)
wipes. Insurance usually covers the expense of screening and treat-
ment, but not the wipes. But providing the CHG wipes to the doctors'
offices at our expense promotes compliance. We've learned that
patients are much more compliant if they don't have to go out and get
the wipes themselves. For elective surgeries, we've achieved 100%
compliance with getting patients to use the wipes. Yes, it's unusual for
facilities to provide wipes, but we've found that going the extra mile
pays off.
• Retest for MRSA. Forty-eight hours after positive patients finish the 5-
day supply of mupirocin and daily CHG wipes, we test them for MRSA
I N F E C T I O N P R E V E N T I O N
Terry Roth, BSN, RN, CNOR
z POST-OP INFECTION A patient whose post-opera-
tive wounds didn't heal properly contracted MRSA 2
years after breast reduction surgery.
Jodi
Jacobson
