TY - JOUR
T1 - Prevention of methicillin-resistant Staphylococcus aureus infections in spinal cord injury units
AU - Evans, Martin E.
AU - Kralovic, Stephen M.
AU - Simbartl, Loretta A.
AU - Obrosky, D. Scott
AU - Hammond, Margaret C.
AU - Goldstein, Barry
AU - Evans, Charlesnika T.
AU - Roselle, Gary A.
AU - Jain, Rajiv
N1 - Funding Information:
The authors thank Meredith Ambrose, MHA, and Kathleen J. Risa, MSN, CRNP, CIC, for coordinating rollout of the Initiative and collecting data along with providing MRSA education to all involved with the Veterans Health Administration MRSA Prevention Initiative; Marta L. Render, MD, and Ron W. Freyberg, MS, for managing the inpatient evaluation center; and the clinical staff of the Veterans Affairs spinal cord injury units, MRSA prevention coordinators, infection preventionists, infectious diseases specialists, and clinical laboratory personnel at each facility for their hard work and dedication toward improving the health care of America’s veterans. This study was supported in part by the Department of Veterans Affairs, Office of Research and Development, Health Services Research and Development Service, Quality Enhancement Research Initiative (RRP 09-163).
PY - 2013/5
Y1 - 2013/5
N2 - Background: Methicillin-resistant Staphylococcus aureus (MRSA) health care-associated infections (HAIs) are a concern in the 22 acute care Veterans Affairs (VA) spinal cord injury units where patients with unique rehabilitation and medical needs and a high risk of infection are treated. Methods: A bundle was implemented in VA spinal cord injury units consisting of nasal surveillance for MRSA on admission/in-hospital transfer/discharge, contact precautions for patients colonized or infected with MRSA, an emphasis on hand hygiene, and an institutional culture change where infection control became everyone's responsibility. Results: From October 2007, through June 2011, there were 51,627 admissions/transfers/discharges and 816,254 patient-days of care in VA spinal cord injury units. The percentage of patients screened increased to >95.0%. The mean admission MRSA prevalence was 38.6% ± 19.1%. Monthly HAI rates declined 81% from 1.217 per 1,000 patient-days to 0.237 per 1,000 patient-days (P <.001). Bloodstream infections declined by 100% (P =.002), skin and soft-tissue infections by 60% (P =.007), and urinary tract infections by 33% (P =.07). Conclusion: Universal surveillance, contact precautions, hand hygiene, and an institutional culture change was associated with significant declines in MRSA HAIs in a setting with a high prevalence of MRSA colonization and a high risk for infection.
AB - Background: Methicillin-resistant Staphylococcus aureus (MRSA) health care-associated infections (HAIs) are a concern in the 22 acute care Veterans Affairs (VA) spinal cord injury units where patients with unique rehabilitation and medical needs and a high risk of infection are treated. Methods: A bundle was implemented in VA spinal cord injury units consisting of nasal surveillance for MRSA on admission/in-hospital transfer/discharge, contact precautions for patients colonized or infected with MRSA, an emphasis on hand hygiene, and an institutional culture change where infection control became everyone's responsibility. Results: From October 2007, through June 2011, there were 51,627 admissions/transfers/discharges and 816,254 patient-days of care in VA spinal cord injury units. The percentage of patients screened increased to >95.0%. The mean admission MRSA prevalence was 38.6% ± 19.1%. Monthly HAI rates declined 81% from 1.217 per 1,000 patient-days to 0.237 per 1,000 patient-days (P <.001). Bloodstream infections declined by 100% (P =.002), skin and soft-tissue infections by 60% (P =.007), and urinary tract infections by 33% (P =.07). Conclusion: Universal surveillance, contact precautions, hand hygiene, and an institutional culture change was associated with significant declines in MRSA HAIs in a setting with a high prevalence of MRSA colonization and a high risk for infection.
KW - MRSA
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U2 - 10.1016/j.ajic.2012.06.006
DO - 10.1016/j.ajic.2012.06.006
M3 - Article
C2 - 23149087
AN - SCOPUS:84876912092
SN - 0196-6553
VL - 41
SP - 422
EP - 426
JO - American Journal of Infection Control
JF - American Journal of Infection Control
IS - 5
ER -
