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Surgical Site Infection Prevention Program

Get Excellent Orthopedic Care at PVHMC

What You Can Do To Prepare For Surgery

Staphylococcus aureus or “Staph” is a germ that lives on the skin and in the nose of some healthy people. Your skin protects you from those germs. When you have surgery, we will be cutting your skin. Sometimes germs can get into those cuts and cause infection.

Screening Process

PVHMC will swab your nose at your Pre Op appointment, 14 days before surgery, to see if you have Staph. The test will take 3-5 days to get the results. The results will be communicated to your Surgeon. A positive test means that Staph is present (this is referred to as being “colonized”) but does not mean you have an infection or illness.

Showering before Surgery

To decrease the amount of germs on your skin, PVHMC is providing you with a medicated soap called Chlorhexidine Gluconate 4% and instructions to cleanse the skin for FIVE consecutive nights before surgery. You will receive this packet when you complete your pre op admission appointment at the hospital. Start the showering process 5 nights before your surgery. (Example: If your surgery date is April 16th then start the showering on April 11th.) The showering is done whether or not the nasal screen is positive or negative for Staph.

CHG 4% Showeringssi program

PVHMC Pre Op Skin Preparation Packet contains 2 bottles of the medicated soap called Chlorhexidine Gluconate (CHG) 4%, a measuring cup, 5 cloth mittens and showering instructions. The instructions will provide you with specific information about showering for FIVE nights in a row before your surgery. Read the showering instructions completely before showering. Follow the instructions for all 5 showers.

Positive Test for Staph

If your test is positive, your surgeon’s office will call you and ask you for the information to your preferred pharmacy. They will call in a prescription for Mupirocin ointment which you will need to pick up from your pharmacy. The medicine will come in one large tube or many small packets. You can call your Clinical Coordinator for any questions concerning the showering and ointment application.

Mupirocin Ointment Application (only if positive for Staph)nasal image

Apply a pea size amount of the ointment to a cotton swab. Place the cotton swab inside your nose, applying the ointment to the inside of the nose. Remove cotton swab and discard. Apply a pea size amount of the ointment to another cotton swab. Place the cotton swab inside the other side of your nose, applying the ointment to the inside of the nose. Remove cotton swab and discard. Gently press your nose together and release, together and release for about one minute to get the medicine all over the inside of your nose. Do this once in the morning and once at night for FIVE days before surgery (the same FIVE days you are showering with CHG soap.) Complete the checklist on the showering instruction sheet for the Mupirocin application.

Day of Surgery

Bring with you the completed checklist (on the showering instruction sheet) and give to the holding room RN (this is the nurse getting you ready for surgery). When you arrive to the holding room you will be given CHG cloths to wipe with from “the neck down except the genitals” before you get dressed in your hospital gown. Before surgery you will receive antibiotics that are appropriate for you according to the nasal swab results.

MRSA (Methicillin-Resistant Staphylococcus Aureus)

If you have a type of Staph called MRSA you will be placed on “Contact Isolation”. This means your doctors and nurses will wear gloves and gowns when taking care of you. We do this to make sure we do not spread MRSA to another patient we are caring for. Your family and visitors will also need to wear gowns and gloves when they visit you in the hospital. When leaving your room, they will need to remove the gowns and gloves and clean their hands with alcohol rub found in the room or the isolation cart outside the room.

Questions?

For any questions, call your Clinical Coordinator at PVHMC or call Pre Admission Testing at PVHMC at 909.865.9546.

References: vll 2/2016; EBBP: AAOS, Orthopaedic Infection Prevention and Control: An Emerging New Paradigm. 2010. EBBP: IHI. How-to Guide: Prevent Surgical Site Infection for Hip and Knee Arthroplasty. 2012. EBBP: AORN, Evidence for Using Chlorhexidine Gluconate Preoperative Cleansing to Reduce the Risk of Surgical Site Infection. Nov 2010.