Quantitative results of a national intervention to prevent hospital-onset methicillin-resistant staphylococcus aureus bloodstream infection: A pre-post observational study

David P. Calfee, Shannon Davila, Vineet Chopra, Payal K. Patel, Ashley Snyder, David Ratz, Andrew J. Rolle, Russell N. Olmsted, Kyle J. Popovich

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) remains one of the most common causes of health care-associated infection (HAI). Objective: To evaluate the effect of education and a tiered, evidence-based infection prevention strategy on rates of hospital-onset MRSA bloodstream infection (BSI). Design: Prospective, national, nonrandomized, interventional, 12-month, multiple cohort, pre-post observational quality improvement project. Setting: Acute care, long-term acute care, and critical access hospitals with a disproportionate burden of HAI. Patients: All patients admitted to participating facilities during the project period. Intervention: A multimodal infection prevention intervention consisting of recommendations and tools for prioritizing and implementing evidence-based infection prevention strategies, ondemand educational videos, Internet-based live educational presentations, and access to content experts. Measurements: Rates of hospital-onset MRSA BSI, overall and stratified by hospital type, during 12-month baseline and postintervention periods. Variation in outcomes across hospital types was examined. Results: Between November 2016 and May 2018, 387 hospitals in 23 states and the District of Columbia participated, 353 (91%) submitted MRSA data, and 172 (49%) indicated that MRSA prevention was a priority. Unadjusted overall rates of hospital-onset MRSA BSI were 0.075 (95% CI, 0.065 to 0.085) and 0.071 (CI, 0.063 to 0.080) per 1000 patient-days in the baseline and postintervention periods, respectively. Limitations: The intervention period was short. Participation and adherence to recommended interventions were not fully assessed. Baseline rates of hospital-onset MRSA BSI were relatively low. Prevention of MRSA was a priority in a minority of participating hospitals. Patient characteristics and other MRSA risk factors were not assessed. Conclusion: In hospitals with a disproportionate burden of HAIs, access to tools to assist with implementation of evidencebased prevention strategies and education resources alone may not be sufficient to prevent MRSA BSI.

Original languageEnglish
Pages (from-to)S66-S72
JournalAnnals of Internal Medicine
Volume171
Issue number7
DOIs
StatePublished - 1 Oct 2019
Externally publishedYes

Fingerprint

Dive into the research topics of 'Quantitative results of a national intervention to prevent hospital-onset methicillin-resistant staphylococcus aureus bloodstream infection: A pre-post observational study'. Together they form a unique fingerprint.

Cite this