Patients’ experiences and compliance with preoperative screening and decolonization

Published:March 23, 2022DOI:


      • Reported adherence was highest at the hospital practicing universal decolonization.
      • Patients vary in their concern about surgical site infections.
      • Patients vary in the effort they will extend to prevent surgical site infections.
      • Few patients reported either barriers to adherence or side effects.



      To improve adherence with pre-surgical screening for Staphylococcus aureus nasal carriage and decolonization, we need more information about patients’ experiences with these protocols.


      We surveyed patients undergoing orthopedic, neurosurgical, or cardiac operations at Johns Hopkins Hospitals (JHH), the University of Iowa Hospitals and Clinics (UIHC) at MercyOne Northeast Iowa Neurosurgery (MONIN) to assess patients’ experiences with decolonization protocols.


      Five hundred thirty-four patients responded. Respondents at JHH were significantly more likely than those at the UIHC to report using mupirocin and were significantly more likely than those at the UIHC and MONIN to feel they received adequate information about surgical site infection (SSI) prevention and decolonization. Respondents at JHH were the least likely to not worry about SSI and they were more willing to do anything they could to prevent SSI. Few patients reported barriers to adherence and side effects of mupirocin or chlorhexidine.


      Respondents did not report either major side effects or barriers to adherence. Patients varied in their level of concern about SSI, their willingness to invest effort in preventing SSI, and their assessments of preoperative information. To improve patients' adherence, clinicians and hospitals should assess their patients’ needs and desires and tailor their preoperative processes, education, and prophylaxis accordingly.


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