Page 21 - Hoag Orthopedic Institute 2014 Outcomes Report

HOAG ORTHOPEDIC INSTITUTE IS ONE OF THE NATION’S 97 “BETTER THAN AVERAGE” PROVIDERS OF ORTHOPEDIC CARE, BASED ON READMISSION AND COMPLICATIONS DATA ON HIP AND KNEE REPLACEMENT SURGERIES NATIONWIDE.
CENTERS FOR MEDICARE & MEDICAID SERVICES, DECEMBER 2013
Methicillin-resistant Staphylococcus aureus (MRSA) Screening Protocol for Inpatient Elective Surgery for Total Hip and Knee Replacement
Nasal Culture (Within 30 days of surgery date)
Positive Nasal Culture (+MRSA)
Culture Results
Negative Nasal Culture (-MRSA)
1. Mupiricin ointment to nasal vestibules twice daily
2. Chlorhexidine Gluconate total body wash or cloth once daily for five days
1. Night prior to surgery, apply Chlorhexidine Gluconate cloth to body after showering
2. Morning of surgery, apply Chlorhexidine Gluconate cloth
to body
Positive Culture
Re-culture nares, axilla, groin and any open wounds after 48 hours of last Mupiricin and Chlorhexidine Gluconate wash
Negative Cultures
Admission to Hospital
Recommended referral to an Infectious Disease Specialist for more intensive decolonization
Clearance to proceed with surgery from Surgeon and/or Infectious Disease Specialist
Preop holding area applies Chlorhexidine Gluconate to surgical site and betadine swab to nares
Surgery
Nasal culture prior to discharge
2014 OUTCOMES REPORT | 21