Last summer, HCRN reported a reduced infection rate using a standardized protocol for shunt surgery1. Since those data went for analysis, we have almost doubled the number of patients on the protocol (now over 3000). We recently reviewed the additional information and our protocol and we are making some changes. The new protocol will be shorter and simpler (which may further enhance compliance). Some steps have been removed and others added. We hope to analyze the new approach in about a year and see if we have further reduced shunt infection.