Patient admitted to an

inpatient unit

History of MRSA found in micro/lab Patient (or provider)

results or records from outside verbally reports suspected
hospital history of MRSA.
No evidence of MRSA in
Order Contact Precautions medical record.
Current MRSA infection Place isolation sign on door
(examples: UTI, BSI, wound
infection, pneumonia)
Clinician orders one nasal
swab to test for MRSA
colonization
Do nothing. Wait until original
infection is resolved or treatment is
completed before beginning
decolonization protocol.
No evidence of active Results = Positive Results = Negative
infection. Original site, if Do nothing
extra-nasal, is healed. Order Contact Precautions
Place isolation sign on door

Begin decolonization 
protocol

If any of the swabs are positive

Clinician orders MRSA
decolonization orderset bundle Do not send any of the
which includes: remaining swabs (if any are
still pending collection)
Intra-nasal Mupirocin Maintain Contact Precautions
(Bactroban) ointment 2% Discontinue orders for any
- BID x5 days additional MRSA screening
(NDC # 45802-112-22) swabs
Daily CHG baths Re-order decolonization
(including axilla & groin) bundle orderset and begin
process again

If all swabs are negative

Contact infection
Wait at least 3 Order nasal swabs to control to remove
days (72 hours) after check for MRSA MRSA flag from
completion of colonization. medical record
decolonization bundle Collect only 1 swab per Discontinue order for
before re-swabbing day (must be on Contact Precautions
nares. separate days). Remove isolation
sign from patient's
door