Reducing Surgical Site Infections by Bundling Multiple Risk Reduction Strategies and Active Surveillance

Abstract 

Postoperative surgical site infections (SSIs) are serious health care-associated infections that contribute to higher rates of mortality. Methicillin-resistant Staphylococcus aureus (MRSA) is an increasingly common cause of SSIs. A quality improvement intervention was developed to identify surgical patients with nasal colonization of MRSA, treat them with mupirocin, and introduce a new preoperative skin antisepsis protocol using 2% chlorhexidine gluconate cloths. The total number of SSIs was reduced by 63%, and MRSA SSIs decreased by 78%. Preoperative MRSA screening and treatment and the preoperative skin antisepsis protocol were smoothly integrated into the facility workflow and well accepted by patients. This intervention saved two community hospitals an estimated $240,000.

Key words: chlorhexidine gluconate, 2% CHG cloths, preoperative skin preparation, surgical site infection, health care-associated infection, methicillin-resistant Staphylococcus aureus