Ramos Nicholas, Skeete Faith, Haas Janet P, Hutzler Lorraine, Slover James, Phillips Michael, Bosco Joseph
Department of Orthopaedic Surgery, NYU Langone Hospital for Joint Diseases, New York, New York, USA.
Bull NYU Hosp Jt Dis. 2011;69(4):312-5.
Although the effect of Staphylococcus aureus (SA) decolonization on surgical site infection (SSI) rates has been studied, patient tolerance and acceptance of these regimens has not been assessed. Surgical patients at our hospital's Pre-Admission Testing Clinic (PAT) receive SA reduction protocols instructing the preoperative use of chlorhexidine gluconate (CHG) soap and intranasal mupirocin ointment (MO). Certain insurers do not cover MO costs resulting in out of pocket (OOP) expenses for some patients.
This study assessed patient attitudes and compliance with our hospital's SA decolonization regimen.
One-hundred-forty-six patients received surveys. Descriptive statistics were used for analysis.
Of respondents fitting inclusion criteria, 81% followed the MO protocol (MO users) while 89% followed the CHG protocol (CHG users). Fifty-four percent of MO users reported OOP expenses and 13% reported a hard or very hard financial burden. Ninety-three percent of CHG users reported the protocol was easy or very easy to follow.
Eighty-one percent of patients receiving the SA protocol were fully compliant despite cost or difficulty obtaining MO. Given these barriers and some difficulty with CHG application, we hypothesize compliance may be improved if MO is provided to patients without OOP expenses and if the CHG application method is simplified.
尽管已经研究了金黄色葡萄球菌(SA)去定植对外科手术部位感染(SSI)发生率的影响,但尚未评估患者对这些方案的耐受性和接受度。我院入院前检查诊所(PAT)的外科患者接受SA减少方案,该方案指导术前使用葡萄糖酸氯己定(CHG)肥皂和鼻内莫匹罗星软膏(MO)。某些保险公司不承担MO费用,导致一些患者需自掏腰包(OOP)。
本研究评估了患者对我院SA去定植方案的态度和依从性。
对146名患者进行了调查。采用描述性统计进行分析。
符合纳入标准的受访者中,81%遵循MO方案(MO使用者),而89%遵循CHG方案(CHG使用者)。54%的MO使用者报告有自掏腰包费用,13%报告有沉重或非常沉重的经济负担。93%的CHG使用者报告该方案易于或非常易于遵循。
尽管存在费用问题或获取MO困难,但81%接受SA方案的患者完全依从。鉴于这些障碍以及CHG应用存在一些困难,我们推测,如果向患者提供免费的MO并简化CHG应用方法,依从性可能会提高。