TYPE Original Research PUBLISHED 17 August 2022 DOI 10.3389/frhs.2022.920830 OPEN ACCESS EDITED BY Erin P. Finley, United States Department of Veterans Affairs, United States REVIEWED BY Michael Sykes, Northumbria University, United Kingdom Nestor Asiamah, University of Essex, United Kingdom *CORRESPONDENCE Stacey Hockett Sherlock stacey.hockettsherlock@va.gov SPECIALTY SECTION This article was submitted to Implementation Science, a section of the journal Frontiers in Health Services RECEIVED 15 April 2022 ACCEPTED 22 July 2022 PUBLISHED 17 August 2022 CITATION Hockett Sherlock S, Goedken CC, Balkenende EC, Dukes KC, Perencevich EN, Reisinger HS, Forrest GN, Pfeiffer CD, West KA and Schweizer M (2022) Strategies for the implementation of a nasal decolonization intervention to prevent surgical site infections within the Veterans Health Administration. Front. Health Serv. 2:920830. doi: 10.3389/frhs.2022.920830 COPYRIGHT © 2022 Hockett Sherlock, Goedken, Balkenende, Dukes, Perencevich, Reisinger, Forrest, Pfeiffer, West and Schweizer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Strategies for the implementation of a nasal decolonization intervention to prevent surgical site infections within the Veterans Health Administration Stacey Hockett Sherlock 1,2 *, Cassie Cunningham Goedken 1 , Erin C. Balkenende 1,2 , Kimberly C. Dukes 1,2 , Eli N. Perencevich 1,2 , Heather Schacht Reisinger 1,2,3 , Graeme N. Forrest 4 , Christopher D. Pfeiffer 5,6 , Katelyn A. West 7 and Marin Schweizer 1,2 1 Center for Access and Delivery Research and Evaluation (CADRE), VA Iowa City Health Care System, Iowa City, IA, United States, 2 Department of Internal Medicine, Carver College of Medicine, The University of Iowa, Iowa City, IA, United States, 3 Institute for Clinical and Translational Science, The University of Iowa, Iowa City, IA, United States, 4 Department of Internal Medicine, Rush University Medical Center, Chicago, IL, United States, 5 Department of Hospital and Specialty Medicine, VA Portland Health Care System, Portland, OR, United States, 6 Department of Medicine, Oregon Health & Sciences University, Portland, OR, United States, 7 VA Portland Healthcare System, Portland, OR, United States As part of a multicenter evidence-based intervention for surgical site infection prevention, a qualitative study was conducted with infection control teams and surgical staff members at three Department of Veterans Affairs Healthcare Systems in the USA. This study aimed to identify strategies used by nurses and other facility champions for the implementation of a nasal decolonization intervention. Site visit observations and field notes provided contextual information. Interview data were analyzed with inductive and deductive content analysis. Interview data was mapped to the Expert Recommendations for Implementing Change (ERIC) compilation of implementation strategies. These strategies were then considered in the context of power and relationships as factors that influence implementation. We found that implementation of this evidence-based surgical site infection prevention intervention was successful when nurse champions drove the day-to-day implementation. Nurse champions sustained implementation strategies through all phases of implementation. Findings also suggest that nurse champions leveraged the influence of their role as champion along with their understanding of social networks and relationships to help achieve implementation success. Nurse champions consciously used multiple overlapping and iterative implementation strategies, adapting and tailoring strategies to stakeholders and settings. Commonly used implementation categories included: “train and educate stakeholders,” “use evaluative and iterative strategies,” “adapt and tailor to context,” and “develop stakeholder interrelationships.” Future research should examine the social networks Frontiers in Health Services 01 frontiersin.org