| Sumario: | Background: Surgical site infections (SSIs) are a major cause of healthcare‐associated infections. Strict compliance to Staphylococcal decolonisation with mupirocin nasal ointment and chlorhexidine wash pre‐cardiac surgery has been shown to prevent SSIs. However, despite existing guidelines, there has been little investigation into adherence and limited interventions have been implemented to improve compliance. Aim: To evaluate the impact of electronic medical record (EMR) order modifications on compliance to Staphylococcal decolonisation protocols in cardiac surgery patients. Method: This was a retrospective pre‐ and post‐intervention study, with data collected from August–December 2022 and February–April 2024, respectively. The intervention involved modifications to EMR orders, specifying a five‐day duration for mupirocin nasal ointment and a new order for chlorhexidine wash cloths with fixed dose, frequency, duration, and indication. Educational sessions were provided to cardiac surgery, nursing, and pharmacy teams. Pre‐ and post‐intervention audits evaluated the effectiveness of the EMR changes on compliance to protocol and examined related pharmacy clinical interventions. This project was exempt due to the local policy requirements that constitute research by the Monash Health Research Office (Research Support Office) (Reference no: RES‐23‐0000‐362Q). The justification for this ethics exemption was as follows: the study conformed with the National Health and Medical Research Council Ethical considerations in quality assurance and evaluation activities, education was incorporated as part of routine scheduled sessions and staff were provided with information on the project as part of the education; consent was not required from staff to attend the education and the study did not involve any assessment of staff. Results: Among 227 patients (n = 118 pre‐intervention, n = 109 post‐intervention) compliance with mupirocin nasal ointment increased from 41.5% to 68.8% (p < 0.001) and compliance with chlorhexidine wash cloths increased from 30.5% to 59.6% (p < 0.001). Compliance with both agents combined rose from 18.6% to 48.6% (p < 0.001). The number of pharmacy interventions relating to decolonisation increased from 16 to 36 (p < 0.001). Conclusion: This study demonstrated that EMR order modifications may improve compliance with the decolonisation protocol in cardiac surgery patients. Targeted education and pharmacy interventions likely contributed to this improvement. Further implementation in a larger, more diverse patient cohort is recommended to ensure generalisability.
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