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Controlling Methicillin-Resistant Staphylococcus aureus: A Feedback Approach Using Annotated Statistical Process Control Charts

  • Evonne T. Curran (a1), James C. Benneyan (a2) and John Hood (a1)

Abstract

Objectives:

To investigate the benefit of a hospitalwide feedback program regarding methicillin-resistant Staphylococcus aureus (MRSA), using annotated statistical process control charts.

Design:

Retrospective and prospective analysis of MRSA rates using statistical process control charts.

Participants:

Twenty-four medical, medical specialty, surgical, intensive care, and cardiothoracic care wards and units at four Glasgow Royal Infirmary hospitals.

Methods:

Annotated control charts were applied to prospective and historical monthly data on MRSA cases from each ward and unit during a 46-month period from January 1997 through September 2000. Results were fed back from December 1999 and then on a regular monthly basis to medical staff, ward managers, senior managers, and hotel services.

Results:

Monthly reductions in the MRSA acquisition rate started 2 months after the introduction of the feedback program and have continued to the present time. The overall MRSA rate currently is approximately 50% lower than when the program began and has become more consistent and less variable within departments throughout Glasgow Royal Infirmary. The control charts have helped to detect rate changes and manage resources more effectively. Medical and nursing staff and managers also report that they find this the most positive form of MRSA feedback they have received.

Conclusions:

Feedback programs that provide current information to front-line staff and incorporate annotated control charts can be effective in reducing the rate of MRSA.

Copyright

Corresponding author

Evonne Curran, Bacteriology Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 OSF , United Kingdom

References

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1.Barrett, SP, Mummery, RV, Chattopadhyay, B. Trying to control MRSA causes more problems than it solves. J Hosp Infect 1998;39:8593.
2.Pittet, D, Waldvogel, FA. To control or not to control colonisation with MRSA that is the question. Q J Med 1997;90:239241.
3.Nettleman, MD, Fredrickson, M, Pfaller, M. Assigning responsibility: using feedback to achieve sustained control of MRSA. Am J Med 1991;91(suppl 3B):228s232s.
4.Sheriden, RL, Weber, J, Benjamin, J, Pasternack, MS, Tomkins, RG. Control of methicillin resistant Staphylococcus aureus in a pediatric burn unit. Am J Infect Control 1994;6:304305.
5.Martin, MA. Methicillin-resistant Staphylococcus aureus: the resistant nosocomial pathogen. Curr Clin Top Infect Dis 1994;14:170191.
6.Benneyan, JC. Statistical quality control methods in infection control and hospital epidemiology: Part 1. Introduction and basic theory. Infect Control Hosp Epidemiol 1998;19:194214.
7.Benneyan, JC. Statistical quality control methods in infection control and hospital: Part 2. Chart use, statistical properties, and research issues. Infect Control Hosp Epidemiol 1998;19:265277.
8.Smyth, ETM, Emmerson, AM. Surgical site infection surveillance. J Hosp Infect 2000;45:173185.
9.Reybrouck, G. Role of the hands in the spread of nosocomial infections. J Hosp Infect 1983;4:103110.
10.Bryan, JL, Cohran, J, Larson, E. Hand washing: a ritual revisited. Critical Care Nursing Clinics of North America 1995;7:46174625.
11.Faoagali, JL, George, N, Fong, J, Davy, J, Dowser, M. Comparison of the antibacterial efficacy of 4% chlorhexidine gluconate and 1% triclosan handwash products in acute clinical ward. Am J Infect Control 1999;27:320326.
12.Working party report revised guidelines for the control of MRSA. J Hosp Infect 1998;39:253290.
13.Vagenvoort, JHT, Sluijsmans, W, Penders, RJR. Better environmental survival of outbreak vs. sporadic MRSA isolates. J Hosp Infect 2000;45:231234.
14.Beard-Pegler, MA, Stubbs, E, Vickery, AM. Observations on the resistance to drying of staphylococcal strains. J Med Microbiol 1988;26:251255.
15.Boyce, JM, Potter-Bynoe, G, Chenevert, C, King, T. Environmental contamination due to methicillin resistant Staphylococcus aureus: possible infection control implications. Infect Control Hosp Epidemiol 1997;9:622627.
16.Benneyan, JC. Use and interpretation of statistical quality control charts. Int J Qual Health Care 1998;10:6973.
17.Plsek, P. Tutorial: introduction to control charts. Quality Management in Health Care 1992;1:6573.
18.Grant, EL, Leavenworth, RS. Statistical Quality Control, 6th ed. New York: McGraw-Hill; 1988.
19.Duncan, AJ. Quality Control and Industrial Statistics. Homewood, IL: Irwin; 1986.
20.Montgomery, DC. Introduction to Statistical Quality Control, 2nd ed. New York: Wiley; 1991.
21.Wenzel, RP, Reagen, DB, Betimo, JS JrBarron, EJ, Arias, K. MRSA outbreak: a consensus panel's definition and management guidelines. Am J Infect Control 1998;26:102110.
22.Haley, RW, Gaynes, RP, Aber, RC, Bennett, JV. Surveillance of nosocomial infections. In: Bennett, JV, Brachman, PS, eds. Hospital Infections, 3rd ed. Boston: Little Brown; 1992.
23.Goldmann, DA, Weinstein, RA, Wenzel, RP, et al. Strategies to prevent and control the emergence and spread of antimicrobial resistant microorganisms in hospitals. JAMA 1996;275:234240.
24.National Audit Office. The Management and Control of Hospital Acquired Infection in Acute NHS Trusts, in England. London: London Stationary Office; 2000.
25.Stone, S, Kibbler, C, How, A, Balestrini, A, Feedback is necessary in strategies to reduce hospital-acquired infection. BMJ 2000;321:302303.
26.Benneyan, JC. Geometric based g-type statistical control charts for infrequent adverse events. Institute of Industrial Engineers (HE) Society for Health Systems Conference Proceedings. Norcross, GA: Institute of Industrial Engineers; 1999:175186.
27.Benneyan, JC. Performance of number-between g-type statistical quality control charts for monitoring adverse events. Health Care Manag Sci 2001;4:319336.

Controlling Methicillin-Resistant Staphylococcus aureus: A Feedback Approach Using Annotated Statistical Process Control Charts

  • Evonne T. Curran (a1), James C. Benneyan (a2) and John Hood (a1)

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