MRSA A Rural Provider Perspective

1
MRSAA Rural Provider Perspective

• William R. Scharf, M.D.
• Division of Strategic Effectiveness
• OSF Healthcare Systems
• Peoria, IL

2
Modes of Transmission

• Handsmain mode
• Contact with colonized or infected patients
• Colonized or infected body sites of health care
  personnel
• Devices, items or environmental surfaces

3
Precautions

• Standard
• Ambulatory
• Home Care
• Long term Care (/- contact precautions)
• Contact
• Acute care settings

4
Contact precautions

• In acute-care hospitals, implement Contact
  Precautions routinely for all patients infected
  with target MDROs and for patients previously
  identified as being colonized with target MDROs
  (e.g. patients transferred from other units or
  facilities who are known to be colonized)
• CDC Management of Multidrug-Resistant Organisms
  in Healthcare Settings, 2006

5
Standard precautions

• Hand hygiene
• Gloving
• Mouth, nose and eye protection
• Gowning
• Appropriate device handling of patient care
  equipment and devices
• Appropriate handling of laundry

6
Contact precautions

• Patient placement
• Gloving
• Gowning
• Patient transport
• Patient care equipment and instruments/devices
• Environmental measures
• Discontinuation of contact precautions

7
Handwashing

• Most important aspect in controlling MRSA
• Requires leadership and teamwork
• Ultimatelya cultural transformation
• Leadership
• Administrative
• Physician
• Nursing
• Measurement
• if you dont measure it, you cant manage it

8
Red Rules

• An error reduction strategy
• Characteristics of Red Rules
• There is strong evidence to support the policy
• The policy is clear
• The measurement is simple
• The policy and supporting evidence is well
  communicated
• There is clear, swift accountability for those
  who fail to support the changes
• Note use sparingly