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The best hospital practices for controlling methicillin-resistant Staphylococcus aureus: on the cutting edge
Meredith S Arnold1, Jane M Dempsey, Marlene Fishman
1Kent Hospital, Warwick, Rhode Island, USA.
Objective:
A performance improvement task force of Rhode Island infection control professionals was created to develop an epidemiologic model of statewide consistent infection control practices that could reduce the spread of methicillin-resistant Staphylococcus aureus (MRSA).
Design:
This model encompasses screening protocols, isolation techniques, methods of cohorting positive patients, decolonization issues, postexposure follow-up, microbiology procedures, and standardized surveillance methodologies. These "best practice guidelines" include three categories of recommendations that define priority levels based on the availability of scientific data.
Setting:
From 1995 through 2000, several Rhode Island hospitals experienced a fivefold increase in nosocomial acquisition of MRSA PARTICIPANTS: Rhode Island infection control professionals are a highly interactive group in the unique position of sharing patients and ultimately experiencing similar trends and problems.
Intervention:
The task force collaborated on developing the best hospital infection control practices to prevent and control the spread of MRSA in Rhode Island.
Results:
The task force met with local infectious disease physicians and representatives from the Rhode Island Department of Health, the Hospital Association of Rhode Island, and Rhode Island Quality Improvement Partners. Discussions identified numerous and diverse MRSA control practices, issues of consensus, and approaches to resolving controversial methods of reducing the spread of MRSA. The guidelines regarding the best hospital practices for controlling MRSA were finalized 8 months later.
Conclusion:
These guidelines were distributed to all chief executive officers of Rhode Island hospitals by the Rhode Island Department of Health in December 2001. They were issued separate and apart from any regulations, with the intent that hospitals will adopt them as best hospital practices in an attempt to control MRSA.
Insights
A task force developed statewide infection control guidelines to combat methicillin-resistant Staphylococcus aureus (MRSA) spread in Rhode Island hospitals. These best practice recommendations aim to standardize MRSA prevention and control efforts across the state.
Area of Science:
- Infectious Disease Epidemiology
- Public Health Policy
- Hospital Infection Control
Background:
- Nosocomial acquisition of methicillin-resistant Staphylococcus aureus (MRSA) increased fivefold in Rhode Island hospitals between 1995 and 2000.
- A need was identified for consistent, statewide infection control practices to address the rising MRSA rates.
Purpose of the Study:
- To develop an epidemiologic model for statewide consistent infection control practices.
- To reduce the spread of methicillin-resistant Staphylococcus aureus (MRSA) across Rhode Island.
Main Methods:
- Formation of a performance improvement task force comprising Rhode Island infection control professionals.
- Development of "best practice guidelines" encompassing screening, isolation, cohording, decolonization, surveillance, and microbiology.
- Collaboration with infectious disease physicians and state health/hospital associations to refine practices.
Main Results:
- Identification of diverse MRSA control practices and areas of consensus.
- Resolution of controversial methods for MRSA reduction.
- Finalization of comprehensive guidelines for best hospital practices in MRSA control within 8 months.
Conclusions:
- Guidelines were distributed to all Rhode Island hospital CEOs in December 2001.
- Hospitals were encouraged to adopt these guidelines voluntarily as best practices for MRSA control.
- The initiative aimed to standardize and improve MRSA prevention statewide.