Enhancing compliance to Staphylococcal decolonisation protocols in cardiac surgery: impact of electronic medical record order modifications.
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 h...
| Publicado en: | Journal of Pharmacy Practice & Research Vol. 55; no. 6; pp. 484 - 492 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Dec2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=190547762&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 190547762 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1445937X 6CKV jtl: Journal of Pharmacy Practice & Research issn: 1445937X maglogo: N pubinfo: dt: Dec2025 vid: 55 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 190547762 186279486 190547762 190547762 10.1002/jppr.70029 190547762 ppf: 484 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Enhancing compliance to Staphylococcal decolonisation protocols in cardiac surgery: impact of electronic medical record order modifications. aug: au: Wu, Maggie Vo, Tin Ryan, Sue Horne, Kylie Hughes, Jessica affil: Pharmacy Department, Monash Health, Melbourne, Australia sug: subj: Patient Compliance Evaluation Staphylococcal Infections Prevention and Control Cardiac Surgery Electronic Health Records Protocols Quality Improvement Electronic Order Entry Human Retrospective Design Pretest-Posttest Control Group Design Record Review Mupirocin Administration and Dosage Ointments Chlorhexidine Administration and Dosage Professional Development Audit Professional Compliance Quality Assurance Descriptive Statistics Pretest-Posttest Design Medication Compliance Surgical Wound Infection Prevention and Control Victoria Middle Age Aged Male Female Chi Square Test Fisher's Exact Test T-Tests Data Analysis Software Surgical Patients Middle Aged: 45-64 years Aged: 65+ years Male Female ab: 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. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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