Wilson Ethan, Marra Alexandre R, Ward Melissa, Chapin Laura, Boulden Stephanie, Ryken Timothy C, Jones Lynne C, Herwaldt Loreen A
University of Iowa College of Public Health, Department of Epidemiology, Iowa City, IA, USA.
University of Iowa Hospitals & Clinics, Iowa City, IA, USA; Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Am J Infect Control. 2023 Jan;51(1):78-82. doi: 10.1016/j.ajic.2022.03.013. Epub 2022 Mar 24.
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.
为提高对金黄色葡萄球菌鼻腔携带和去定植的术前筛查的依从性,我们需要更多关于患者对这些方案体验的信息。
我们对在约翰霍普金斯医院(JHH)、爱荷华大学医院及诊所(UIHC)以及梅西医疗中心东北爱荷华神经外科(MONIN)接受骨科、神经外科或心脏手术的患者进行了调查,以评估患者对去定植方案的体验。
534名患者做出了回应。JHH的受访者报告使用莫匹罗星的可能性显著高于UIHC的受访者,并且比UIHC和MONIN的受访者更有可能觉得他们获得了关于预防手术部位感染(SSI)和去定植的充分信息。JHH的受访者最不可能不担心SSI,并且他们更愿意尽一切可能预防SSI。很少有患者报告依从性障碍以及莫匹罗星或氯己定的副作用。
受访者未报告主要副作用或依从性障碍。患者对SSI的关注程度、预防SSI的意愿投入以及对术前信息的评估各不相同。为提高患者的依从性,临床医生和医院应评估患者的需求和愿望,并相应地调整术前流程、教育和预防措施。