[yankeecamper]

Does anyone have a protocol for preop antibiotic wound prophylaxis on pts with antibiotic resistant organisms? I am a PACU/SDSU supervisor and we have had a few MRSA pts return to surgery with wound infections.

[ITSJUSTMEZOE]

The majority that I have seen is they carry on the protocol of ancef, gent. I have seen those more than others. It seems to be mute at times but thats what I have been seeing.
Zoe

[yankeecamper]

Yes, our facility does that. However, ancef is not the antibiotic of choice. I heard of something about bactroban on the nares of colonized pts a few days before surgery, but I have not seen any protocols about this.

[ITSJUSTMEZOE]

Another thing that we do to try to decrease exposure to others is we bring patients with MRSA or VRE straight to the OR. No pre op stops straight down, they are the last case of the day for that room because then its terminal. Broken down and cleaned. I go up in full garb and mask and pick up patient which I have masked as well, and covered from neck to feet with large blanket. To the OR, tranferred to OR table and bed broken down and scrubbed and cleaned resheeted and bed made up for transport(my gown and such changed upon entry of the OR, red bagged and dumped). All items on patient I clean myself and return back to patient. Cleaned and ready for use back on the floor. If I have to take the patient to PACU after the case I let them know when I have first notification of case and they keep the isolation room available for that case. It seems to work well, Its a hard bug to kill and to be honest not one you want to flaunt in an OR or PACU.
Yeah I have heard of the bactroban on the nares but some patients cant tollerate a wad of that stuff up their snozz, so I use the mask.
Hope this helps. I shot an email to another friend of mine in surgery to see what they do shes on the east coast and she does infection control, when she hollars back at me I will hollar at ya
Zoe

[yankeecamper]

Thanks. Our pts go directly to the OR from the floor, also. We gown up ,etc. We also remove uneeded equipment or supplies from the OR suite and designate a staff person to run for unexpected supplies and place them in the passthru. Have you ever wondered how many pts coming to the OR have MRSA and we just don't know? HMMMM.

[ITSJUSTMEZOE]

Im sure it happens there are many times we go into the OR without some lab results , but we take the precautions with all the patients and the room is cleaned and everything stripped in between all patients like Im sure it is with your facility.
Zoe