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Methicillin-resistant Staphylococcus aureus (MRSA) and surgical site infection (SSI) prevention is a complex and multifaceted effort. This toolkit highlights four general surgical areas of care for intervention that are the most impactful in targeting MRSA prevention. How you approach the topic of tackling these areas depends on what’s right for your facility, surgical service, and setting. The four perioperative phases of MRSA prevention can help guide you and your team to address MRSA and SSI prevention in cardiac, hip and knee joint replacement, and spinal fusion surgeries. This same information is presented by intervention type in “The 4 Key Strategies of MRSA Prevention.”

Office/Home Phase

• Antimicrobial Prophylaxis
• Hand Hygiene
• MRSA Surveillance
• Nasal Decolonization
• Use of Preoperative Chlorhexidine Antisepsis
• Decolonization Resources*

Pre-op Phase

• Antimicrobial Prophylaxis
• Contact Precautions 
• Optimizing Environmental Cleaning
• Hair Removal 
• Hand Hygiene
• Normothermia
• Nasal Decolonization
• Use of Preoperative Chlorhexidine Antisepsis

Surgery Phase

• Antimicrobial Prophylaxis
• Optimizing Environmental Cleaning
• Glycemic Control
• Hand Hygiene 
• Normothermia
• Operating Room Traffic
• Skin Preparation Prior to Incision
• Supplemental Oxygen

Post-Op Phase

• Antimicrobial Prophylaxis
• Contact Precautions
• Optimizing Environmental Cleaning
• Glycemic Control
• Hand Hygiene
• Normothermia
• Supplemental Oxygen

Notes:

*Importance of MRSA and SSI Prevention

*Review of SSI Prevention Program Tools