Reducing Perioperative S. Aureus Transmission

The purpose of this study is to prevent the spread of S. aureus, a dangerous bacterium,
within the operating room and between patients undergoing surgery. The investigators will
combine several approaches in a "bundle" of activities to achieve this goal. The bundle will
include removal of bacterial pathogens from patient skin sites before surgery, from provider
hands before, during, and after surgery, from environmental surfaces before and after
terminal cleaning, and from the injection ports of patient intravenous catheters. The
investigators will use a new surveillance system to evaluate how well the bundle, and each
component of the bundle, is working. Surveillance will identify S. aureus transmission
events, and movement of S. aureus between reservoirs before, during, and after surgery
(perioperative). Surveillance will map transmission events to identify actionable steps to
improve the bundle. An infection control perioperative team will act on the surveillance
reports to proactively address the action items, and to measure the effect of their efforts
for the treatment group. The investigators will compare perioperative S. aureus transmission
events for patients receiving the bundle to perioperative S. aureus transmission events for
patients receiving usual care.

Inclusion Criteria:

- At least 18 years of age

- Undergoing surgery (orthopedic total joint, orthopedic spine, Gynecological/Oncology,
thoracic, general, hernia, colorectal, open vascular, plastic surgery and open
urological)

- Ability to sign informed consent

- Require general or regional anesthesia

Exclusion Criteria:

- Less than 18 years of age

- Inability to sign informed consent

- Procedures not included above

- Not requiring general or regional anesthesia