Keywords

cardiac surgery, mupirocin prophylaxis, MRSA

Abstract

The CDC estimates that one in 20 patients admitted to the hospital is a carrier of methicillin-resistant Staphylococcus aureus (MRSA). Staphylococci are commonly found on the skin and mucous membranes within the anterior nares, which provides the principle reservoir for this organism. These organisms can go on to cause surgical site infections in hospitalized patients. Mupirocin is an effective topical medication used to eliminate nasal carriage of Staphylococcus aureus (S. aureus). Based on Level A evidence, the 2007 Society of Thoracic Surgeons has made a Class I recommendation for the use of mupirocin for all patients undergoing cardiac surgery in the absence of documentation of a negative culture for staphylococcal colonization. The purpose of this before-and-after study is to examine the rates of surgical site infections (SSI) for cardiac surgery patients who came through the pre-admission testing unit prior to same-day admission (SDA) for surgery before and after providing 2% mupirocin nasal ointment. Specific aims: 1. To examine the relationship between providing mupirocin to the SDA cardiac surgery patient and the prevalence of SSI. 2. To examine the cost-effectiveness of providing mupirocin to the SDA cardiac surgery patient and SSI. 3. To examine the adherence of SDA preoperative cardiac surgery patients and the use of mupirocin preoperatively, if the medication is provided at no cost to the patient. Retrospective chart reviews were completed on 330 patients: 175 patients in the pre-provision of mupirocin and 150 in the mupirocin provided group. Chi Square and students' t-tests were used to analyze the data. There were five SSIs in the pre-provision of mupirocin group and no SSIs in the mupirocin provided group. This was a significantly statistical difference between the groups (X2 = 4.497, p > 0.5) Continued provision of 2% nasal mupirocin to prevent SSI in the cardiac surgery patients is recommended.

Notes

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Graduation Date

2010

Advisor

Wink, Diane

Degree

Doctor of Nursing Practice (D.N.P.)

College

College of Nursing

Department

Nursing

Degree Program

Nursing Practice

Format

application/pdf

Identifier

CFE0003342

URL

http://purl.fcla.edu/fcla/etd/CFE0003342

Language

English

Release Date

August 2010

Length of Campus-only Access

None

Access Status

Doctoral Dissertation (Open Access)

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Included in

Nursing Commons

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