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Ide E, Bondar S, Hockett Sherlock S, Schweizer-Looby ML, Naylor J, Kane K, Meade R, Anderson H, Uttech C, Murphree D, McKinley L, Stampfli C, Perencevich EN, Crnich C. A Multidisciplinary Evaluation of Staphylococcus aureus Screening, Decolonization and Patient Adherence to Pre-Operative Decolonization Procedures. Open forum infectious diseases. 2017 Oct 7; 4(Suppl 1):S641-S642.
Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects. Background Colonization with Staphylococcus aureus (SA) increases the risk of surgical site infection (SSI) and de-colonization reduces this risk depending on level of patient adherence. Our VA facility's participation in a multi-site study to identify the best strategies for implementing peri-operative SA de-colonization provided an opportunity to examine the reliability of existing internal processes. The objectives of this single-site study were to asses self-reported patient adherence, and barriers to recommended de-colonization procedures, as well as to examine if current patient educational materials were sufficient. Methods A survey measuring self-reported adherence and barriers to recommended de-colonization procedures was administered by telephone. A process map of the patient education process was employed to identify key frontline staff who were asked to review existing patient education materials and procedures. A new patient education tool was then developed with their input and input from an expert in patient education. Results 34 patients responded to the telephone interview. Self-reported de-colonization adherence was 100%. 32% of patients reported high levels of social/economic deprivation and only 32% reported using medication reminders, suggesting some risk of non-adherence. Process mapping revealed that patient education was delivered through a combination of face-to-face training and printed materials. Review of the printed materials identified a number of opportunities for improvement. The newly developed patient education tool was rewritten at a 7th grade reading level and revised to include: (1) more concrete information on the benefits of SA de-colonization; (2) visual aides to enhance performance of different de-colonization tasks; and (3) a tracking log to facilitate adherence to each of the recommended de-colonization tasks. Conclusion We identified many opportunities to improve the education of patients undergoing SA de-colonization prior to high-risk surgery at our VA. Further work will need to be done to determine whether these changes positively impacted patient adherence to recommended de-colonization procedures and whether this translates into improved patient outcomes.
