Assignment: Infection Control Professionals

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Assignment: Infection Control Professionals

Assignment: Infection Control Professionals

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As MRSA infection rates have climbed, more and more attention has focused on preventing the spread of these superbugs. In addition to strict hand hygiene, successful strategies for controlling MRSA include screening patients using active surveillance cultures, isolating patients colonized with MRSA, using gowns, gloves, and masks when treating them, and routine decontamination of patient rooms and operating rooms.15

Many hospitals in northern Europe have used these strategies to successfully control MRSA infections for decades. MRSA made up 33 percent of all staph infections in Denmark in the 1960s, but has declined steadily after aggressive control practices were instituted and has hovered around 1 percent for the past 25 years.16 Likewise, the prevalence of MRSA has been kept under .5 percent in both Finland and the Netherlands.17

APIC found that only 29 percent of infection control professionals it surveyed for its 2007 MRSA prevalence study reported that their hospitals used active surveillance cultures to identify patients who are colonized with MRSA. Fifty percent of the infection control professionals

surveyed said their hospital “was not doing as much as it could or should to stop the transmission of MRSA.”18

A number of hospitals in the U.S. following this “bundle” of infection control strategies have documented impressive results. A pilot program at the Veterans Health Administration’s (VHA) Pittsburgh Healthcare System in Pennsylvania in 2001 has reduced infections in the hospital’s surgical unit by 70 percent.19

All patients admitted to the hospital underwent a nasal swab upon admission to screen for MRSA. Patients who tested positive were isolated from other patients and were treated by health care workers who wore disposable gowns, masks, and gloves. Medical equipment – like stethoscopes and blood pressure cuffs – was disinfected after each use. Patients received another nasal swab right before discharge to see if they developed a MRSA infection during treatment.20

This pilot was so successful that the VHA issued a directive in January 2007 “to interrupt the chain of transmission of MRSA” by requiring all of its 150 hospitals to follow this MRSA protocol. Initially, the directive required screening patients in intensive care units, then in other high risk units such as transplant units and general surgical wards, and continuing to phase in other units of the hospitals “until all inpatient areas (with the exception of inpatient psychiatry) are incorporated in the initiative.”21

 

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