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Can a nasal and skin decolonization protocol safely replace contact precautions for MRSA-colonized patients?

Published:January 13, 2020DOI:https://doi.org/10.1016/j.ajic.2019.12.016

      Highlights

      • Contact precautions can adversely impact patient safety and patient experience
      • Contact precautions were replaced with a nasal and skin decolonization protocol
      • An alcohol-based nasal antiseptic was dosed twice daily, with daily CHG bath
      • Statistically significant cost reductions were realized without an increase in MRSA
      • Majority of staff indicated preference for alcohol-based antiseptic over mupirocin
      Contact precautions (CP) are employed in United States hospitals in order to prevent transmission of pathogens via supplies, equipment, and health care worker hands. CP is required in many hospitals for both colonized and infected methicillin-resistant Staphylococcus aureus (MRSA) patients. The isolation of colonized patients often results in a high rate of CP, leading some hospitals to abandon CP for MRSA-colonized patients without adding any safety measure to address transmission risk. Understanding this risk, 7 network hospitals in a US health care system made the decision to replace CP for high-risk MRSA-colonized patients with targeted nasal and body decolonization, leading to significant cost savings and staff satisfaction without any increase in MRSA transmission.

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