Barriers and Enablers in Home-Based Staphylococcus aureus Decolonisation Among Orthopaedic Surgery Patients: A Qualitative Study.
Greta Ghizzardi, Rosario Caruso, Gianfranco Barra and 8 others
PMID 41891931WHAT IT FOUND
Patients preparing for hip or knee replacement described surprise and fear after a positive test result or before surgery.
Clear instructions and nurse or GP support were described as helping them follow home decolonisation; late notices, tight timing, and missing products hindered it.
Key findings
01Patients often did not know they carried S. aureus before screening, and learning the result or facing surgery triggered surprise and fear.
02Adherence was described as easier when instructions were clear and when nurses or GPs gave practical support, such as a phone call or written information.
03Four participants reported non-adherence, and their accounts pointed to late communication, short timing, and limited access to products rather than intentional refusal.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included 20 patients from a private hospital in northern Italy, so it may not reflect public systems, other countries, or other surgical populations. Participants reported their own experiences after the fact, so memory and a wish to give a favourable answer may shape the accounts. Qualitative themes cannot show how common each barrier was or prove that any factor caused adherence. The paper did not measure surgical site infections, so it cannot show that decolonisation reduced them. Only four participants reported non-adherence, and adherence was not verified from medical records.
Declared interests
The authors report no funding and no conflicts of interest.
The easy way to misread this
Do not conclude that home decolonisation prevents surgical site infections from this paper. It reports patient experiences and self-reported adherence, not infection outcomes.