Universal Inpatient Screening for Methicillin Resistant Staphylococcus Aureus (MRSA) Substantially Reduces Noscomial MRSA Infection Rates: May 2007 to May 2012

do not shave, use depilatories, wax, or apply lotion on leg(s)/hip(s) prior to surgery. Educate patients about personal hand hygiene, inform patient not to touch dressing or incisions unless absolutely necessary, instruct patients to shower the evening before and the morning of surgery using chlorhexidine gluconate (CHG) for 2 days, distribute literature regarding patient education If patient is MRSA/ MSSA positive, instruct patient to shower with CHG for 5 days and use Mupirocin nasal ointment 5 days pre-op. Dressing Protocol: Use silver or specialty dressings, remove after 5 days, if excessive drainage occurs, nursing will change dressing. Discharge Assessment, Teaching and Follow-up: Review home care orders to reinforce understanding regarding physical therapy, medications, and signs and symptoms of infection. RESULTS: Quarterly standardized infection ratios (SIRs) were developed and presented for the system, hospitals, and individual orthopedic surgeons. Overall system and hospitals’ SIRs are reflected graphically. LESSON LEARNED: Due to numerous preventive interventions, total knees’ and total hips’ SIRs decreased below 1.0 during the last four current quarters. Continuation of monitoring compliance with practices in OR with staff is occurring. Feedback of SIRs with orthopedic surgeons happens on a quarterly basis. Opportunities for improvement, including sharing information with infection prevention committees and surgical teams, is ongoing.