1132. Universal Staphylococcal Decolonization for Elective Surgeries: the Patient Perspective
Session: Poster Abstract Session: MRSA/VRE Epidemiology
Friday, October 9, 2015
Room: Poster Hall
Posters
  • IDWEEk.pdf (219.1 kB)
  • Background:

    To decrease post-operative infections, we implemented a universal staphylococcal decolonization (USD) protocol for elective surgeries beginning in October 2013. To assess our process, we evaluated patient perceptions, compliance, and barriers to USD.

    Methods:

    From November 2014 to April 2015, a 9-item anonymous, voluntary, Likert scale survey was distributed to patients undergoing elective neurosurgical and orthopedic surgeries.

    Results:

    A total of 405 patient surveys were collected (n=1049, 39%). The majority (401, 99.0%) received a complete USD kit consisting of nasal mupirocin, and chlorhexidine mouthwash and chlorhexidine soap.

     

    Statement

    (n=405)

    Strongly Agree/Agree

    Neutral

    Strongly Disagree/Disagree

    No Response

    Patients undergoing elective orthopedic/neuro surgery are at risk for staphylococcal infection.

    80%

    7.4%

    4.2%

    8.2%

    I was given instructions on how to use the USD kit.

    98%

    0.7%

    1.0%

    0.0%

     The USD instructions were easy to understand.

    98%

    0.5%

    1.3%

    0.2%

    Using the USD kit decreases your risk of developing a staph infection.

    94%

    3.7%

    1.7%

    0.1%

    Overall global compliance with USD was 85%. Compliance (n=405) with use of nasal ointment was 86%, mouthwash 84% and soap 84%. No statistically significant differences were found when comparing neurosurgical and orthopedic patient responses across survey elements. The most common barrier for not completing USD was insufficient time (<5 days) prior to surgery (n=73).

     

    Conclusion:

    Patients undergoing elective procedures in orthopedics and neurosurgery feel that USD is beneficial for SSI risk reduction. Survey respondents reported receiving clear instructions on USD. Self-reported compliance with USD was high (85%) across both services. No significant differences were observed between services in compliance, perceptions and barriers to USD.  Insufficient time prior to surgery was the largest barrier to USD completion. Programs instituting USD for elective surgeries must clearly communicate potential benefits of decolonization, minimize inconvenience, and optimize timing of USD. Ongoing assessment of compliance and barriers with feedback to primary services is needed for maximal implementation and benefit of USD.

    Nadia Masroor, BS1, Gonzalo Bearman, MD, MPH, FSHEA2, Kaila Cooper, MSN, CIC3, Kakotan Sanogo, MS1, Michael Stevens, MD, MPH4 and Jenika Ferretti-Gallon, BS1, (1)VCU Medical Center, Richmond, VA, (2)Infectious Diseases, Virginia Commonwealth University Medical Center, Richmond, VA, (3)Virginia Commonwealth University, Richmond, VA, (4)Infectious Diseases, Virginia Commonwealth University, Richmond, VA

    Disclosures:

    N. Masroor, None

    G. Bearman, None

    K. Cooper, None

    K. Sanogo, None

    M. Stevens, None

    J. Ferretti-Gallon, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.