Abstract
887. Implementation of a Surgical Site Infection (SSI) Prevention Bundle: Patient Compliance and Experience
Open forum infectious diseases, Vol.7(Supplement_1), pp.S478-S479
12/31/2020
DOI: 10.1093/ofid/ofaa439.1075
PMCID: PMC7777201
Abstract
Abstract
Background
An evidence-based preoperative bundle including chlorhexidine gluconate (CHG) bathing, screening for S. aureus nasal carriage and decolonizing carriers with mupirocin was the standard of care for patients having total joint arthroplasty (TJA) at a VA medical center. We aimed to assess patient compliance with mupirocin and CHG, and characterize patient perceptions of barriers and facilitators to compliance.
Compliance with CHG Bathing & Mupirocin By Methicillin-resistant S. aureus (MRSA) or Methicillin-susceptible S. aureus (MSSA) Colonization Status
Methods
The bundle for S. aureus colonized patients having TJA included nasal mupirocin ointment twice daily and daily CHG bathing for 5 days before surgery. The bundle for non-carriers included CHG bathing the day before and the morning of surgery. From 7/2018-10/2019, inpatients completed a 31-item survey following their TJA.
Results
73 patients completed the survey (~29% of the TJA population). 17 patients (23%) carried S. aureus & 56 patients (77%) were non-carriers. Patients reported high compliance with home use of CHG for the full number of days directed (88% when prescribed for 2 days; 71% when prescribed for 5 days; overall 85% used as prescribed; Figure). 7 (10%) patients reported CHG side effects, including burning or itchy/dry skin. 99% of patients reported willingness to use the CHG before a future surgery. Compliance with home use of mupirocin was lower (53% used as prescribed). Reported side effects included stinging, itching or dryness (N=2, 12%), unpleasant taste (N=2, 12%) & runny or stuffy nose (N=3, 18%). 100% of patients reported willingness to use mupirocin before a future surgery. Barriers to patient compliance with the bundle included forgetfulness and difficulty bathing daily. Facilitators to patient compliance included high facility compliance with S. aureus screening (100% patients reported), patient education regarding CHG and mupirocin use (95% patients recalled), and access to prescribed medications (100% patients received). Most patients (93%) reported no financial burden for mupirocin and 95% of patients reported no financial burden for CHG.
Conclusion
Patients reported high willingness to use the prevention bundle, yet mupirocin compliance was sub-optimal. Replacing patient-applied home mupirocin with nurse-applied day-of-surgery decolonization should be assessed in order to facilitate increased compliance.
Disclosures
All Authors: No reported disclosures
Details
- Title: Subtitle
- 887. Implementation of a Surgical Site Infection (SSI) Prevention Bundle: Patient Compliance and Experience
- Creators
- Stacey Hockett-Sherlock - University of IowaDaniel Suh - Iowa City VA Health Care SystemEli N Perencevich - University of IowaHeather Schacht Reisinger - University of IowaJudy Streit - University of IowaGosia Clore - University of IowaMadeline Ohl - University of IowaLoreen Herwaldt - University of IowaMarin L Schweizer - University of Iowa
- Resource Type
- Abstract
- Publication Details
- Open forum infectious diseases, Vol.7(Supplement_1), pp.S478-S479
- DOI
- 10.1093/ofid/ofaa439.1075
- PMCID
- PMC7777201
- ISSN
- 2328-8957
- eISSN
- 2328-8957
- Language
- English
- Date published
- 12/31/2020
- Academic Unit
- Infectious Diseases; Epidemiology; Center for Social Science Innovation; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984363299902771
Metrics
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