As a result of process improvements and patient satisfaction initia-
tives, we eliminated our pre-admission testing (PAT) clinic. This
process change added value to patients and their families. We provide
pre-op teaching to families over the phone. We discuss safety meas-
ures and the SSI bundle components, but the families were no longer
required to come to the hospital before surgery. This required us to
get creative about getting MRSA swabs.
Initially, we mailed the swabs to patients' families, along with an
illustrated educational pamphlet. Families were instructed to swab
the child and drop the swab off at their insurance approved local lab
for testing. However, there were obstacles there, too. Some insurance
mandated labs do not have a PCR (polymerase chain reaction)
machine, so they had to run the test as a culture. The problem with
this is it forced the labs to run the test as a culture, which takes 3
days, versus the 2 hours for a PCR. Additionally, we saw many incon-
sistencies with the outside labs. For example, occasionally we'd get
results back and it would turn out that the swabs had been tested for
something other than MRSA.
Our own machines
In 2018, our hospital decided that the quality and reliability of
accurate MRSA results was necessary to improve outcomes for our
patients. All the MRSA screenings are now completed in our own
lab at the hospital. We have 2 PCR machines, so time and space
were not concerns to support this new initiative. Now, when
patients come in to meet the surgeon, usually a couple of weeks
before the surgery, we have them present to the outpatient lab for
their MRSA screening. If the schedule changes, or if there is an
add-on surgery, we can do the testing on the day of surgery.
Children who live outside the immediate vicinity of the hospital
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