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MRSA Prevention Toolkit: Targeting SSI

Decolonization Resources

Nasal Decolonization

Preoperative Skin Antisepsis

Preoperative skin antisepsis and nasal decolonization together are a proven strategy used to reduce the risk of surgical site infections (SSIs). Skin antisepsis with chlorhexidine (CHG) reduces the number of bacteria on the skin and protects patients when they are at high risk for infection such as the perioperative period. Skin antisepsis with CHG and decolonization require dedicated effort from staff, but the potential benefit is very impactful. Nasal decolonization effectively removes MRSA and methicillin-susceptible Staphylococcus aureus (MSSA) from the nose.

Decolonization has been shown to be effective among surgical patients in cardiac, hip and knee joint replacement, and spinal fusion surgeries. Whether or not your surgical department employs universal or targeted decolonization depends on a variety of factors, but these resources are helpful for everyone undergoing decolonization.

To review the evidence for nasal decolonization and preoperative CHG skin antisepsis, access this toolkit’s main topic page on Nasal Decolonization, as well as this toolkit’s main topic page on Use of Preoperative Chlorhexidine Antisepsis, which provide presentations and other learning materials. Below you’ll find resources to help implement decolonization as part of your infection prevention practices.

First Steps: Decision Making and Prelaunch Activities

The resources in this section are designed to provide comprehensive guidance for healthcare workers who are considering or planning a decolonization program. These resources cover essential steps, from making critical early decisions to planning prelaunch activities.

Protocol Documents

Below are sample protocols for skin antisepsis with CHG and nasal decolonization with mupirocin or iodophor. Multiple methods for CHG skin antisepsis and nasal decolonization are addressed.

Staff Training Documents

This set of documents aims to educate staff members on decolonization.

Decolonization Training Presentations

These presentations educate staff on the various methods of nasal decolonization as well as preoperative skin antisepsis with CHG. 

FAQs

These documents assist in addressing frequently asked questions about preoperative decolonization.

Talking Points

These documents provide salient talking points for staff to assist in patient education on decolonization.

Sample Scripts

These documents provide an easy-to-follow script for staff to use when educating patients about the various nasal decolonization methods and preoperative skin antisepsis with CHG.

Other Staff Training Resources

Patient Documents

This set of documents aims to educate patients on decolonization prior to surgery, with resources for both nasal decolonization methods and skin antisepsis with CHG. Included are sample calendars to help patients keep track of their progress in the 5 days leading up to their surgery.

Patient Instructions: Decolonization

These patient instructions provide step-by-step insight into the use of various decolonization products prior to surgery. The language is presented for an audience without a clinical background to ensure patient compliance and accuracy in administering at-home decolonization.

Patient Decolonization Calendar

These calendars help patients keep track of their at-home decolonization prior to surgery. There are several different versions of calendars available, depending on product utilized and protocol suggested by their provider. 

 

This page is part of the Office/Home Phase of this toolkit. Other pages in the phase include:

 

Page last reviewed September 2025
Page originally created April 2025

Internet Citation: Decolonization Resources. Content last reviewed September 2025. Agency for Healthcare Research and Quality, Rockville, MD.
https://www.ahrq.gov/hai/tools/mrsa-prevention/surgery/decolonization-resources.html

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