Major ArticlePatients’ experiences and compliance with preoperative screening and decolonization
Section snippets
INTRODUCTION
Staphylococcus aureus causes over 30% of surgical site infections (SSIs)1 and these infections increase morbidity and healthcare costs.2, 3, 4 According to data from the National Health Safety Network5 and data from individual medical centers, S. aureus is the single most common cause of SSIs after total joint arthroplasties,6,7 cardiac operations,8,9 spinal operations,10,11 and craniotomies,12,13 causing 21%-63% of these infections.6, 7, 8, 9, 10, 11, 12, 13 Fifteen to 30% of adults in the
METHODS
A convenience sample of adult patients age 18 or older who underwent THA or TKA at Johns Hopkins Hospitals (JHH); TKA, cardiac, spine, or cranial operations at the University of Iowa Hospitals and Clinics (UIHC); and spine or cranial operations at MercyOne Northeast Iowa Neurosurgery (MONIN) completed the survey between April 2017 and September 2018. Patients were assigned unique study identification numbers.
The orthopedics team at JHH gave the survey to patients on their first post operative
RESULTS
Five hundred thirty-four surveys were returned: 100 from JHH, 214 from the UIHC, and 220 from MONIN. Respondents’ ages ranged from 18 to 90 years with an average age of 58.1 years (N = 481; due to a clerical error, age was missing for 51 patients at JHH). Age varied significantly between hospitals (Table 1; P = .0005); patients at JHH were the oldest and those at MONIN were the youngest. The proportion of female to male respondents ranged from 43.2% to 50.5%; the differences were not
DISCUSSION
S. aureus nasal carriage is a risk factor for S. aureus SSI infections and numerous studies have shown that preoperative decolonization of carriers decreases the risk.4,15, 16, 17, 18, 19, 20 However, decolonization has not been implemented in many hospitals.21,22 In addition, we previously found that adherence with screening and preoperative decolonization with five days of intranasal mupirocin and CHG bathing is less than optimal.18 During our prior multicenter quasiexperimental trial, 39% of
ACKNOWLEDGMENTS
The authors gratefully acknowledge the patients who shared their experiences with us and the staff in the surgical clinics at the University of Iowa Hospitals and Clinics, the Johns Hopkins Hospital, and MercyOne Northeast Iowa Neurosurgery for distributing and collecting the surveys. We also acknowledge Dr. Harpal (Paul) Khanuja's assistance with the survey.
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Cited by (0)
Conflicts of Interest: None to report.
Funding: The study was funded by grant 1R18HS022467-01 from the Agency for Healthcare Research and Quality.
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Current affiliation: Dartmouth-Hitchcock Medical Center, Lebanon, NH.
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Current affiliation: Johns Hopkins School of Medicine, Baltimore, MD.