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Barriers and Enablers in Home-Based Staphylococcus aureus Decolonisation Among Orthopaedic Surgery Patients: A
Greta Ghizzardi1, Rosario Caruso2,3, Gianfranco Barra4
1Directorate of Nursing and Allied Health Professions, ASST di Lodi, Lodi, Italy.
Nursing Open
|March 27, 2026
Summary
Understanding patient adherence to Staphylococcus aureus decolonisation is key for arthroplasty success. This study identified psychological and organisational barriers, alongside facilitators, to improve home-based decolonisation protocols.
Area of Science:
- Medical Microbiology
- Patient Adherence Research
- Surgical Infection Prevention
Background:
- Staphylococcus aureus (S. aureus) nasal carriage is a significant risk factor for surgical site infections, particularly in patients undergoing arthroplasty.
- Preoperative decolonisation protocols aim to reduce S. aureus burden, but adherence can be challenging.
- Optimizing patient adherence to home-based decolonisation is crucial for effective infection prevention in arthroplasty surgery.
Purpose of the Study:
- To explore the barriers and facilitators influencing patient adherence to home-based Staphylococcus aureus decolonisation protocols.
- To gain insights into patient experiences and perceptions of the decolonisation process.
- To inform the development of strategies to improve adherence and reduce infection risk in arthroplasty patients.
Main Methods:
- A phenomenological qualitative study design was employed.
- Semi-structured interviews were conducted with 20 adult patients undergoing arthroplasty who tested positive for S. aureus.
- Thematic analysis was used to identify recurring themes related to patient experiences, psychological factors, and organisational aspects.
Main Results:
- Seven distinct themes were identified, categorized into three primary domains: psychological barriers, facilitators to adherence, and organisational barriers.
- Psychological factors such as motivation and understanding of the protocol significantly impacted adherence.
- Facilitators included clear communication and perceived effectiveness of the treatment, while organisational issues related to healthcare system support also played a role.
Conclusions:
- Patient adherence to home-based S. aureus decolonisation is multifactorial, influenced by psychological, organisational, and individual patient factors.
- Addressing identified barriers and leveraging facilitators can enhance protocol adherence.
- Improved adherence strategies are essential for reducing S. aureus related complications in arthroplasty patients.
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