Archive Infection Control 2019

We Succeeded With Nasal Decolonization

Our protocol is easy to implement, cost-effective and widely accepted by patients.

Joanne Epstein

Joanne Epstein, BSN, RN, CNOR


Kate Johnston/Saint Francis Hospital
NEW APPROACH Saint Francis Hospital eliminated the need for patients to perform nasal decolonization at home in favor of an onsite program — and its SSI rate has steadily declined.

When patients arrive at our hospital's same day surgery unit, we give them a package of 2% chlorhexidine wipes and ask them to rub down the surgical site. Then, about an hour before their procedure, a pre-op nurse snaps open an ampule containing an alcohol-based sanitizer and instructs them to swab the inside of each nostril. Staphylococcus aureus pathogens that lurk in the nares are killed in a matter of minutes.

The application is simple to perform, which belies its importance. Research has shown that one-third of the general population is colonized with nasal S. aureus and 80% of surgical site infections are caused by bacteria that originates in the nose.

Treating patients with the sanitizer is inexpensive — about $3 per patient. We crunched the numbers and predicted we'd need to spend $18,000 for a year's worth of product. Compare that to upwards of $30,000 for treating a single SSI and the cost-benefit is abundantly clear.

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