Bundle component/measures | Evidence/rationale for inclusion | |
---|---|---|
New evidence-based infection control practices | ||
1. Nasal screening and decolonization | Screen patients for SA carriage and decolonize SA carriers with 5 days of intranasal mupirocin [15, 16] because SA nasal colonization has been shown to be associated with an increased risk for SSI | |
1.a. | Pre-operative nasal screening for Staphylococcus aureus (SA) carriage | |
1.b. | Intranasal mupirocin prescribed for methicillin-resistant S. aureus (MRSA) carriers | |
1.c. | Intranasal mupirocin prescribed for methicillin-resistant S. aureus (MRSA) carriers | |
2. | Chlorhexidine bathing 3 or more times pre-operatively | Instruct patients to bathe or shower with chlorhexidine gluconate (CHG) for at least 3 days before surgery [17–19] to reduce bacterial colonization of the skin prior to surgery (regardless of SA carriage) |
3. | Alcohol-containing antiseptic used to prepare skin in operating room | Use an alcohol-containing antiseptic agent for pre-operative skin preparation [20, 21] because the use of alcohol in addition to a long-acting antiseptic agent provides superior protection against SSIs |
Previously promoted infection control practices from the Surgical Care Improvement Program (SCIP) | ||
4. Peri-operative intravenous antibiotics | SCIP practice 1 | |
4.a. | Timely receipt of prophylactic intravenous antibiotics | |
4.b. | Peri-operative intravenous vancomycin for MRSA carriers | |
5. | Appropriate hair removal technique (not razor) | SCIP practice 2 |