Archive March 2019 XX, No. 3

Fighting MRSA Infection With a Tissue and a Swab

Nasal decolonization as part of a bundled approach can help reduce wound infections.

Dan O

Dan O'Connor, Editor-in-Chief


Pamela Bevelhymer, RN, BSN, CNOR
SWAB 'EM ALL Easy-to-apply povidone iodine and ethanol nasal decolonization products let more surgical facilities routinely swab patients an hour or so before surgery.

Soon after a total joint or a colon resection patient settles into his pre-op room at Mercy Health St. Elizabeth Boardman (Ohio) Hospital, he's greeted by a nurse holding a box of tissues in one hand and a package of antiseptic nasal swabs in the other.

She offers him a tissue and asks him to blow his nose. Then the nurse tilts the patient's head back, opens a 4-pack of povidone iodine swabs and swirls the inner and anterior rim of each nostril for about 15 seconds apiece, and then repeats the process. If preferred, the patient can swab himself.

The cost of nasal decolonization: a Kleenex, $15 for a package of swabs and 2 minutes of a pre-op nurse's time. The payoff: fewer MRSA or associated wound infections. A lot fewer.

"Compared to the cost of one infection, I'd say our return on investment was a positive one, as our colon SSI rate decreased significantly," says Maria Sliwinski, RN, BSN, MHHS, CNOR, clinical resource specialist for surgical services at St. Elizabeth Boardman, which trialed and implemented nasal antiseptic decolonization to its SSI bundled interventions a few years ago to address a widespread MRSA problem, knowing that nasal S. aureus is a major risk factor for a surgical site infection.

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