T
he couple minutes
you spend applying a
nasal antiseptic to
joint replacement
patients before they
undergo surgery is well worth
your time. I tested the impact
nasal decolonization had on my
hospital's hip and knee arthro-
plasty outcomes and discovered
the easy-to-apply method
improved an already low SSI rate
— and resulted in more than
$400,000 in avoided costs associ-
ated with treating post-op infec-
tions. Before achieving these
impressive results, we had to
reassess how patients were
prepped for procedures and
determine the best approach
moving forward.
A new method
Through periodicals and other
infection prevention resources,
the infection prevention depart-
ment at the hospital became
aware of several products that
were available to reduce the
intranasal colonization of methi-
cillin-resistant Staphylococcus
aureus (MRSA) and methicillin-
sensitive Staphylococcus aureus
(MSSA). It has been estimated
that MRSA is the responsible pathogen in 63% of
SSIs occurring after total joint replacements. We
discovered that up to one-third of the population is
colonized with MSSA or MRSA on their skin and in
their nose, and that it could possibly cause them to
have an infection in the site where they have
surgery. We also learned that none of the hospitals
in our health system were using nasal decoloniza-
tion as an SSI prevention tool, but the practice was
in place at other facilities in our region.
I wanted to keep our hospital in line with the oth-
ers in the area, so I looked at how Emory University
Hospital — one of the top facilities in the Atlanta
area — managed their joint replacement patients.
3 2 • O U T P A T I
E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 2 1
Nasal Decolonization Slashed Our SSI Rates
The simple pre-op practice eliminated infections
and saved our hospital several hundred thousand dollars.
Susan Franklin, RN I Austell, Ga.
DOLLARS AND SENSE Standardized nasal decolonization is a cost-effective alternative to treatment with mupirocin ointment.
Pamela
Bevelhymer