GIRFT guide on streamlining protocols for decolonisation and washes

GIRFT has added to its popular series of resources supporting the streamlining of preoperative processes to maximise theatre efficiency, with guidance on preoperative decolonisation interventions and washes before elective surgery. 

Audits around decolonisation have shown wide variation in practice across preoperative assessment (POA) services, and GIRFT’s feedback from providers suggests that protocols for preoperative decolonisation interventions and washes are often a limiting factor in offering short notice cancellations to patients waiting for surgery. 

The new guidance offers advice for both adults and children and young people (CYP) and had input from the BOA’s Rhidian Morgan-Jones and Professor Mike Reed. 

It aims to provide practical steps on surgical patients who require preoperative skin washing treatments, particularly where patients may be offered a theatre date at short notice due to a late cancellation and the impact on patients who have been issued with treatment extending past that date. Utilising theatre time more efficiently is key to ensuring a return to 18-week referral to treatment (RTT) for patients. 

The new GIRFT advice covers:  

• Indications for and timing of preoperative decolonisation interventions and/or washes (including special consideration for patients identified as positive for MRSA/MSSA). 
• The type of decolonisation intervention and washes used, and risks to consider. 
• Patient information about decolonisation interventions and washes. 
• Auditing and researching practice on decolonisation interventions and SSI. 

A further section outlines the evidence base regarding SSI and decolonisation practice, including national evidence and GIRFT’s survey results. 

The four other guides in the GIRFT series (early screening, risk assessment and optimisation; NT-ProBNP and echocardiography; local anaesthetic and MRSA testing) are available on the GIRFT website here.