Methicillin-resistant Staphylococcus aureus prevention practices in hospitals throughout a rural state

作者：McDanel Jennifer S^*; Ward Melissa A; Leder Laurie; Schweizer Marin L; Dawson Jeffrey D; Diekema Daniel J; Smith Tara C; Chrischilles Elizabeth A; Perencevich Eli N; Herwaldt Loreen A

来源：American Journal of Infection Control, 2014, 42(8): 868-873.

DOI：10.1016/j.ajic.2014.05.004

• Methicillin-resistant Staphylococcus aureus
• Hospital-associated infections
• Prevention
• Institute for Healthcare Improvement

Background: The Institute for Healthcare Improvement (IHI) created an evidence-based bundle to help reduce methicillin-resistant Staphylococcus aureus (MRSA) health care-associated infections. The study aim was to identify which components of the IHI's MRSA bundle that rural hospitals have implemented and to identify barriers that hindered implementation of bundle components.
Methods: Four surveys about the IHI's MRSA bundle were administered at the Iowa Statewide Infection Prevention Seminar between 2007 and 2011. Surveys were mailed to infection preventionists (IPs) who did not attend the meetings.
Results: The percentage of IPs reporting that their hospital implemented a hand hygiene program (range by year, 87%-94%) and used contact precautions for patients infected (range by year, 97%-100%) or colonized (range by year, 77%-92%) with MRSA did not change significantly. The number of hospitals that monitored the effectiveness of environmental cleaning significantly increased from 23%-71% (P < .01). Few hospitals assessed daily if central lines were necessary (range by year, 22%-26%). IPs perceived lack of support to be a major barrier to implementing bundle components.
Conclusion: Most IPs reported that their hospitals had implemented most components of the MRSA bundle. Support within the health care system is essential for implementing each component of an evidence-based bundle.

• 出版日期2014-8