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Saturday, March 20, 2010
Grand Hall (Hyatt Regency Atlanta)
Background: Methicillin Resistant Staph aureus (MRSA) now counts for greater than 50% of hospital-acquired S.aureus infections and 63% of S.aureus infections in the intensive care units in the U.S.
A MRSA infection can increase length of stay (LOS) by 9.1 days
The Institute for Healthcare Improvement(IHI) 5 Million Lives Campaign has recommended five components of care for MRSA control:
Hand Hygiene
Decontamination of the Environment
Active Surveillance Cultures
Contact Precautions for Infected/Colonized Patients
Device Bundles ( Central Line Bundle, Ventilator Bundle and UTI Bundle)
In March 2007, the following components were initiated in the ICU :
· Nasal cultures are performed on patients at entry in the ICU.
· Patients colonized with MRSA are isolated.
· The antibiotic ointment mupiricin is administered to all PCR positive patients to prevent or treat colonization.
· Dedicated thermometers are used for all critical care unit patients.
· Additional waterless alcohol-based hand sanitizers were installed in patient rooms.
Objective: Eliminate the transmission of MRSA infections/colonization.
Methods: The hospital was enrolled and collaborated with Quality Improvement Organizations (QIO) to meet the requirements of the CMS Ninth Scope of Work (9thSOW) MRSA Reduction Project. Infection Control and Prevention Department began to collect MRSA data from the ICU on MRSA-HAI and MRSA clinical isolates in October 2008. Results were collected retrospectively from January 2007.
Results: Proxy measures of MRSA infections were obtained by analyzing culture reports from the laboratory system sent to Infection Control on a quarterly basis. Clinical evaluation of the patient was not performed. The goal was to reduce MRSA transmission in the unit by 40%. The following MRSA metrics formula was used for analysis:
MRSA Infection/colonization incidence density rate: Number of 1st labID Events per patient month among those with no documented prior evidence of previous infection or colonization with MRSA and identified > 3days after admission to the ICU/ Number of patient days for the ICU X 1000.
Conclusions: The promotion of proven and currently recommended infection control strategies resulted in zero transmission of MRSA in the ICU for more than one year since July 2008. Strategies include:handwashing;surface and skin decontamination/sterile technique/antibiotic stewardship.
Epidemiologic approaches include: Isolation, typing/tracking of spread of organisms within and between wards/units. Outcomes include:reduced length of stay/ reduced morbidity and possible cost reduction for treatments.
A MRSA infection can increase length of stay (LOS) by 9.1 days
The Institute for Healthcare Improvement(IHI) 5 Million Lives Campaign has recommended five components of care for MRSA control:
Hand Hygiene
Decontamination of the Environment
Active Surveillance Cultures
Contact Precautions for Infected/Colonized Patients
Device Bundles ( Central Line Bundle, Ventilator Bundle and UTI Bundle)
In March 2007, the following components were initiated in the ICU :
· Nasal cultures are performed on patients at entry in the ICU.
· Patients colonized with MRSA are isolated.
· The antibiotic ointment mupiricin is administered to all PCR positive patients to prevent or treat colonization.
· Dedicated thermometers are used for all critical care unit patients.
· Additional waterless alcohol-based hand sanitizers were installed in patient rooms.
Objective: Eliminate the transmission of MRSA infections/colonization.
Methods: The hospital was enrolled and collaborated with Quality Improvement Organizations (QIO) to meet the requirements of the CMS Ninth Scope of Work (9thSOW) MRSA Reduction Project. Infection Control and Prevention Department began to collect MRSA data from the ICU on MRSA-HAI and MRSA clinical isolates in October 2008. Results were collected retrospectively from January 2007.
Results: Proxy measures of MRSA infections were obtained by analyzing culture reports from the laboratory system sent to Infection Control on a quarterly basis. Clinical evaluation of the patient was not performed. The goal was to reduce MRSA transmission in the unit by 40%. The following MRSA metrics formula was used for analysis:
MRSA Infection/colonization incidence density rate: Number of 1st labID Events per patient month among those with no documented prior evidence of previous infection or colonization with MRSA and identified > 3days after admission to the ICU/ Number of patient days for the ICU X 1000.
Conclusions: The promotion of proven and currently recommended infection control strategies resulted in zero transmission of MRSA in the ICU for more than one year since July 2008. Strategies include:handwashing;surface and skin decontamination/sterile technique/antibiotic stewardship.
Epidemiologic approaches include: Isolation, typing/tracking of spread of organisms within and between wards/units. Outcomes include:reduced length of stay/ reduced morbidity and possible cost reduction for treatments.