MRSA Prevention Toolkit: ICUs & Non-ICUs

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:

Which Type of Decolonization Would Work Best in My Unit? (DOCX, 500 KB)