Checklist to Prevent MRSA Surgical Site Infections
Surgical Site Infection
About this trial
This is an interventional prevention trial for Surgical Site Infection focused on measuring MRSA, surgical site infection
Eligibility Criteria
Inclusion Criteria:
Retrospective Control Group Inclusion Criteria:
- Patients identified in VA databases (e.g. VASQIP) by ICD-9 procedure codes as undergoing total joint arthroplasty or cardiac surgery at the 10 intervention VA Medical Centers during the 5 year preintervention period (2008-2013)
Concurrent Non-equivalent Control Group Inclusion Criteria:
- Patients identified in VA databases (e.g. VASQIP) by ICD-9 procedure codes as undergoing total joint arthroplasty or cardiac surgery at VA Medical Centers not included in the intervention group during the 8 years evaluated (5 years pre-intervention to match with the retrospective control group and 3 years of the intervention.)
Exclusion Criteria:
For All Patient Groups:
- Have an ICD-9 diagnosis code consistent with endocarditis
- Have any documented infection before the surgical procedure
- Undergo cardiac transplants or cardiac procedures performed using the percutaneous or thoracotomy approach
- Undergoing hip and knee revisions
- Documented allergies to mupirocin
Sites / Locations
- Miami VA Healthcare System, Miami, FL
- Iowa City VA Health Care System, Iowa City, IA
- Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD
- VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA
- VA Ann Arbor Healthcare System, Ann Arbor, MI
- Minneapolis VA Health Care System, Minneapolis, MN
- Omaha VA Nebraska-Western Iowa Health Care System, Omaha, NE
- VA Portland Health Care System, Portland, OR
- South Texas Health Care System, San Antonio, TX
- VA Salt Lake City Health Care System, Salt Lake City, UT
- William S. Middleton Memorial Veterans Hospital, Madison, WI
Arms of the Study
Arm 1
Experimental
Surgical Site Infection Checklist
Patient has a known positive Staph aureus pre-op screening result (MRSA or MSSA): ecolonize with intranasal Mupirocin ointment BID x 5 days hlorhexidine gluconate (CHG) bathing (daily x 5 days, using wipes or liquid) efazolin plus Vancomycin (no Vanco for MSSA positive) Patient has a known negative Staph aureus pre-op screening result: HG bathing (night before & morning of surgery using wipes or liquid) efazolin Patient was not screened or results are unknown at time of surgery: ecolonize with intranasal Mupirocin ointment (start BID x 5 days; discontinue if negative screen) HG bathing (start daily bath 5 days before operation if possible; at a minimum bathe the night before & morning of surgery using wipes or liquid) efazolin plus Vancomycin