All patients being evaluated for Total or Subtotal Pancreatectomy with IAT will receive a staph screen molecular lab to evaluate for Oxacillin resistant/Methicillin resistant Staphylococcus aureus (ORSA/MRSA) as part of their pre-operative evaluation.
If the previous staph screen was completed greater than 12 months ago, a repeat staph screen should be obtained prior to surgery
If staph screen is negative, no additional follow up is needed
If staph screen is abnormal for Staphylococcus aureus, the patient is colonized with MSSA not MRSA, the ORSA/MRSA guideline is not indicated/necessary
If staph screen is positive for ORSA/MRSA, the following steps will be taken:
PCC provider or RN will notify the family of the positive staph screen
PCC RN or PCC APRN will electronically prescribe Mupirocin 2% nasal ointment to be utilized prior to surgery. Instructions: apply inside each nostril with a cotton swab twice daily for 7 days prior to surgery
PCC RN will review and provide a copy (in person, via MyChart or by mail) of the Pre-Operative Instructions for a Positive Staph Screen Knowing Note which includes staph screen positive pre-operative teaching including:
- Provision for Mupirocin 2% prescription with application details
- Instructions to begin Chlorhexidine Gluconate skin cleanser
every other day for 7 days prior to surgery
- Knowing Note can be found at: http://centerlink.cchmc.org/-/media/af8ed152842e4f559fc4b350f6100926.pdf
Surgeon will utilize an agent that covers MRSA as part of surgical prophylaxis (Vancomycin) in peri-operative plan