Accepted Manuscript Empowering the Surgical Patient: A Randomized, Prospective Analysis of an Innovative Strategy for Improving Patient Compliance to the Preadmission Showering Protocol Charles E. Edmiston, Candace J. Krepel, MS Sarah E. Edmiston, MEd Maureen Spencer, MEd Cheong Lee, MD Kellie R. Brown, MD, FACS Brian D. Lewis, MD, FACS Peter J. Rossi, MD, FACS Michael Malinowski, MD Gary Seabrook, MD, FACS PII:

S1072-7515(14)00303-2

DOI:

10.1016/j.jamcollsurg.2014.01.061

Reference:

ACS 7361

To appear in:

Journal of the American College of Surgeons

Received Date: 8 November 2013 Revised Date:

26 January 2014

Accepted Date: 27 January 2014

Please cite this article as: Edmiston Jr CE, Krepel CJ, Edmiston SE, Spencer M, Lee C, Brown KR, Lewis BD, Rossi PJ, Malinowski M, Seabrook G, Empowering the Surgical Patient: A Randomized, Prospective Analysis of an Innovative Strategy for Improving Patient Compliance to the Preadmission Showering Protocol, Journal of the American College of Surgeons (2014), doi: 10.1016/ j.jamcollsurg.2014.01.061. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

ACCEPTED MANUSCRIPT

Empowering the Surgical Patient: A Randomized, Prospective Analysis of an Innovative Strategy for Improving Patient Compliance to the Preadmission Showering Protocol

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Charles E Edmiston Jr, PhD, Candace J Krepel, MS, Sarah E Edmiston, MEd, Maureen Spencer, MEd, Cheong Lee, MD, Kellie R Brown, MD, FACS, Brian D Lewis, MD, FACS, Peter J Rossi,

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MD, FACS, Michael Malinowski, MD, Gary Seabrook, MD, FACS

Department of Surgery (Division of Vascular Surgery), Surgical Microbiology Research

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Laboratory, Medical College of Wisconsin, Milwaukee, WI

Disclosure Information: This study was supported in part by a grant to Dr Edmiston from

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CareFusion. All other authors have nothing to disclose.

Running title: Electronic Alert as a Strategy for Improving Patient Compliance

Charles E. Edmiston, Jr., PhD, Professor of Surgery, Division of Vascular Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53225 [email protected]

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Correspondence address:

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ACCEPTED MANUSCRIPT

Abstract Background: Surgical site infections (SSIs) are responsible for significant morbidity, mortality and excess utilization of healthcare resources. The preadmission antiseptic shower is accepted as

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an effective strategy for reducing the risk of SSI. The following study analyzes the benefit of an innovative electronic patient alert system (EAS) for enhancing compliance to a preadmission showering protocol with 4% chlorhexidine gluconate (CHG).

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Study Design: Following informed consent 80 volunteers were randomized to four CHG

showering groups: A1 and A2, showered twice, A1 was prompted to shower via EAS; B1 and

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B2, showered three times, B1 was prompted via EAS. A2 and B2 subjects were not prompted (Non-EAS). Skin surface skin concentrations of CHG (µg/mL) were analyzed using colorimetric assay at 5 separate anatomic sites. Study personnel were blinded to the randomization code, following final volunteer processing the code was broken and individual groups analyzed.

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Results: Mean composite CHG skin-surface concentrations were significantly higher (p