Checklist to Prevent MRSA Surgical Site Infections

• Status: Completed
• Trial end date: 2021-02-28
• Target enrollment: 0
• Participant gender: All

Summary

The goals of this project are 1) to assess the effectiveness and cost-effectiveness of the checklist to prevent MRSA SSIs among Veterans undergoing TJA or cardiac surgery, and 2) to assess barriers and facilitators to checklist implementation.

Hypotheses:

1. The SSI checklist will be effective at reducing MRSA SSIs among total joint arthroplasty and cardiac surgery patients.

2. Implementation of the checklist will be associated with an overall reduction in SSIs caused by all pathogens.

3. The SSI Checklist will be cost-saving since it will prevent many expensive SSIs.

4. Preoperative MRSA testing will be a modifiable barrier to implementing the SSI checklist.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Iowa City Veterans Affairs Medical Center; VA Office of Research and Development
• Treatments: Cefazolin; Chlorhexidine; Chlorhexidine gluconate; Iodine; Mupirocin; Povidone; Povidone-Iodine; Vancomycin

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