Decolonization is a proven strategy for MRSA prevention. By reducing the body's bacterial burden of MRSA, decolonization protects patients from transmission and infection, especially during hospitalization, when they are most vulnerable to infection. Implementing decolonization does require dedicated effort from healthcare staff, but the potential benefits for patient safety and healthcare outcomes are significant.
On this page, you will find educational material on decolonization, including detailed presentations, to provide an understanding of the process of decolonization, the published evidence, and keys for implementation success.
One critical decision that healthcare teams must address early in their planning is to choose between a Universal Decolonization or Targeted Decolonization strategy. Detailed guidance on how to make this decision is provided below.
This page also links to the Tools and Resources for Decolonization provided by this Toolkit, including guidelines, tools, training materials, and patient education resources. There resources are designed to support units and facilities in planning and executing successful decolonization programs.
Presentations
After reviewing the content of this presentation, viewers will be able to:
Discuss the importance of decolonization for MRSA prevention.
Review the evidence behind use of chlorhexidine gluconate (CHG) for skin decolonization.
Review the evidence behind nasal decolonization.
Discuss universal versus targeted strategies for decolonization.
Provides a concise summary of pivotal studies on the topic of decolonization. For more details, please refer to the first presentation on this page, The Evidence Behind Decolonization Strategies for MRSA.
Designed as a practical tip sheet offering top ten pearls of wisdom for implementing CHG and nasal decolonization.
Universal Versus Targeted Decolonization
Before implementing decolonization, you will need to decide whether to implement Universal Decolonization or Targeted Decolonization. These strategies are outlined below.
Universal Decolonization:
is a strategy wherein: All patients in a specific hospital unit are treated with nasal decolonization for 5 days and decolonized with CHG bathing daily throughout their stay in the unit.
is recommended for use in ICUs. This includes all adult and pediatric ICUs, though the evidence is stronger for adult ICUs.
is sometimes appropriate for use in non-ICU units, such as step-down units and medical, surgical or other units with high acuity patients (i.e., Oncology)
should be considered for units with a high percentage of patients who have an increased MRSA risk due to the presence of central lines, midline catheters, PICC lines, or lumbar drains.
is appropriate to use in hospital units with high MRSA acquisition rates, regardless of patient acuity or presence of medical devices
Targeted Decolonization:
is a strategy wherein: Only targeted patients at higher risk for MRSA infection in a specific hospital unit are treated with nasal decolonization for 5 days and decolonized with CHG bathing daily throughout their stay in the unit.
is recommended for use in non-ICU units where some, but not all patients are at higher risk for MRSA infection due to having devices such as central lines, midline catheters, PICC lines, or lumbar drains.
is appropriate to decolonize patients identified as being infected or colonized with MRSA using an active or passive MRSA surveillance strategy.
This information can be also downloaded as a standalone document:
Visit the Tools & Resources for Decolonization page to explore guides, protocols, staff training materials and patient educational resources. Links to individual sections are linked below.
Decolonization First Steps, Readiness, and Pre-Launch This section covers Readiness and Pre-Launch. It is recommended to start here. The guides provided in this section walk you through key early decisions and the preparatory steps for launch.
Decolonization Protocols Access sample unit and nursing protocols for bathing with chlorhexidine gluconate (CHG) and conducting nasal decolonization.
Internet Citation: Decolonization. Content last reviewed October 2024. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/hai/tools/mrsa-prevention/toolkit/decolonize-patients.html
