Surgical site infection (SSI) and methicillin-resistant Staphylococcus aureus (MRSA) prevention can be approached from multiple directions. Interventions may consist of a bundle of practices, adapted to the needs of your site.
Below is an index of all the clinical topics that are included in this toolkit. Each topic contains presentations on current evidence and best practices, along with relevant resources. Click on each of the sections to see more.
Importance of MRSA and SSI Prevention
MRSA is one of the most invasive and deadly multidrug-resistant organisms (MDROs). Preventing MRSA and SSIs among surgical patients is a crucial patient safety goal. This section provides an overview of MRSA, the harms it poses, the sources and pathways of MRSA, and general key concepts for MRSA and SSI prevention.
MRSA Surveillance
MRSA is one of the most invasive and deadly MDROs. There are two strategies towards decolonization as a MRSA prevention technique: targeted and universal. This section explores when use of one strategy over another is appropriate and how to implement this infection prevention technique.
Nasal Decolonization
Decolonization is the reduction of bacteria on the patient’s body to reduce the risk of invasive infection and transmission. Nasal decolonization is proven as one of the most effective methods of preventing MRSA and SSIs based on current evidence. This toolkit includes extensive resources and materials to assist in the implementation of nasal decolonization in your surgical service.
Use of Preoperative Chlorhexidine Antisepsis
In surgery, skin antisepsis is an important practice to reduce microbial burden and the risk of surgical site infection/MRSA infection. Bathing with CHG prior to surgery is a key strategy to reduce MRSA and SSIs and protect the surgical patient.
Antimicrobial Prophylaxis
All patients who undergo cardiac, hip and knee joint replacement, and spinal fusion surgical procedures must take some form of antimicrobial prophylaxis. This section discusses cefazolin, the golden standard antimicrobial prophylactic agent, as well as when the addition of vancomycin is appropriate, proper dosage and timing, and more.
Hand Hygiene in the Perioperative Setting
Hand hygiene is a fundamental infection prevention practice. Improving and maintaining adherence among staff to hand hygiene guidelines is an effective MRSA prevention strategy. This section discusses hand hygiene, its impact on MRSA and SSI prevention, and implementation of hand hygiene adherence monitoring.
Contact Precautions
MRSA spreads via contact transmission between individuals. Use of transmission-based precautions and contact isolation is widely recommended to address transmission risk. This section discusses contact precaution policies and the impact they can have on MRSA prevention.
Optimizing Environmental Cleaning
Contamination of the patient environment is a key pathway of transmission that should be addressed as part of any MRSA and SSI prevention effort. This section presents an overview of the key components of designing and improving environmental cleaning and the implementation of interventions.
Perioperative Infection Prevention Strategies
This section discusses the importance of several different perioperative infection prevention strategies with guidance for implementation of interventions.
Preoperative Hair Removal
This section discusses recommendations for hair removal prior to surgery.
Normothermia
This section discusses the importance of maintaining normothermia in the perioperative phases.
Skin Preparation Prior to Incision
This section discusses the importance of skin preparation prior to incision.
Supplemental Oxygen
This section discusses the evidence for supplemental oxygen in the perioperative setting as it relates to MRSA and SSI prevention.
Glycemic Control
This section discusses the importance of glycemic control in the perioperative setting as it relates to MRSA and SSI prevention.
Operating Room Traffic
This section discusses the importance of minimizing operating room traffic to prevent MRSA and SSI.
Review of SSI Prevention Program Tools
This section discusses the various tools and resources available in this toolkit to help prevent MRSA and SSI.
