between intake and transport to the OR. Each swab lasted about 30
seconds. The patient's assigned and labeled bottle traveled with the
chart to the PACU. After leaving the OR, we made additional applica-
tions at 3 p.m. and/or 9 p.m. on the day of surgery, depending upon the
time of arrival in the PACU. On each subsequent day in the hospital,
PACU staff applied the nasal antiseptic to the patient at 9 a.m., 3 p.m.
and 9 p.m. We sent patients home with what was left in the 12 mL bot-
tle and encouraged them to continue applications every 6 hours for 5 to
7 days.
We collected data from a total of 803 spine surgery patients, 399 dur-
ing the 9-month baseline period and 403 during the 9 months of nasal
antiseptic use. The mean SSI rate during the reference period was
1.76 infections per 100 surgeries. This rate was reduced to 0.55 during
the subsequent 9-month period of nasal antiseptic use in our protocol:
a 69% decrease.
The success of this ongoing effort has led other surgical groups within
our hospital to try nasal antiseptics. Critical to its success has been the
leadership and motivation provided by key members of the nursing and
surgical teams, and the participating staff's enthusiasm.
OSM
M A R C H 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 7 1
Ms. Mullen (amullen@uspi.com) is the infection prevention manager at Baylor
Orthopedic & Spine Hospital in Arlington, Texas.
