Infection Control Results, a North Carolina-based consulting firm.
Patients can be educated on how to use CHG wipes or bathing solu-
tion during a pre-op clinic appointment. You can also distribute the
wipes or solution in kits that include directives on how and when to
apply the CHG and bottles containing the specific amount of solution
that should be used during each application. Some facilities even use
engagement apps to send patients text message reminders when it's
time to apply the CHG.
Ms. Perri says you can't always be certain of how well — or if —
patients prep their skin before they arrive for surgery, so she suggests
applying CHG in pre-op on and around the intended surgical site to
ensure the bacterial count on the area is decreased.
Providing patients with clear wound care directives in discharge
instructions is just as important as the efforts you make before sur-
gery to reduce infection risks, notes Ms. Perri, recalling a case where
a patient, due to inadequate discharge information, didn't bathe for a
week after his procedure.
Also be sure to properly apply skin prepping solutions in the OR.
"It's important to follow the manufacturer's instructions," says Ms.
Perri. For example, studies suggest it's best to apply a chlorhexidine
gluconate-isopropyl solution using a back-and-forth technique as
opposed to the circular application techniques suggested by most
povidone-iodine prep manufacturers.
2. Nasal decolonization
Studies have shown that approximately 80% of surgical site infections
are caused by bacteria that originates from the patient's nasal flora, find-
ings that point to the importance of nasal decolonization.
You can screen all patients for MRSA in the weeks leading up to sur-
gery to identify and treat carriers with the topical antibiotic mupirocin,
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