Skip to main content Accessibility help
×
Home

Hospital Staff Perceptions of a Legislative Mandate for Methicillin-Resistant Staphylococcus aureus Screening

  • Matthew E. Wise (a1), Stephen G. Weber (a2), Amy Schneider (a1), Meg Stojcevski (a2), Anne Marie France (a3), Melissa K. Schaefer (a1), Michael Y. Lin (a4), Alexander J. Kallen (a1) and Ronda L. Cochran (a1)...

Abstract

Objective.

In August 2007, Illinois passed legislation mandating methicillin-resistant Staphylococcus aureus (MRSA) admission screening for intensive care unit patients. We assessed hospital staff perceptions of the implementation of this law.

Design.

Mixed-methods evaluation using structured focus groups and questionnaires.

Setting.

Eight Chicago-area hospitals.

Participants.

Three strata of staff (leadership, midlevel, and frontline) at each hospital.

Methods.

All participants completed a questionnaire and participated in a focus group. Focus group transcripts were thematically coded and analyzed. The proportion of staff agreeing with statements about MRSA and the legislation was compared across staff types.

Results.

Overall, 126 hospital staff participated in 23 focus groups. Fifty-six percent of participants agreed that the legislation had a positive effect at their facility; frontline staff were more likely to agree than midlevel and leadership staff (P < .01). Perceived benefits of the legislation included increased awareness of MRSA among staff and better knowledge of the epidemiology of MRSA colonization. Perceived negative consequences included the psychosocial effect of screening and contact precautions on patients and increased use of resources. Most participants (59%) would choose to continue the activities associated with the legislation but advised facilities in states considering similar legislation to educate staff and patients about MRSA screening and to draft clear implementation plans.

Conclusion.

Staff from Chicago-area hospitals perceived that mandatory MRSA screening legislation resulted in some benefits but highlighted implementation challenges. States considering similar initiatives might minimize these challenges by optimizing messaging to patients and healthcare staff, drafting implementation plans, and developing program evaluation strategies.

Copyright

Corresponding author

Division of Healthcare Quality Promotion, CDC, 1600 Clifton Road, MS A-35, Atlanta, GA 30333 (cxx4@cdc.gov)

References

Hide All
1.Klevens, RM, Morrison, MA, Nadle, J, et al.Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA 2007;298(15):17631771.
2.Weber, SG, Huang, SS, Oriola, S, et al.Legislative mandates for use of active surveillance cultures to screen for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enter-ococci: position statement from the Joint SHEA and APIC Task Force. Infect Control Hosp Epidemiol 2007;28(3):249260.
3.Illinois General Assembly. Public Act 095-0312: MRSA Screening and Reporting Act. http://www.ilga.gov/legislation/publicacts/95/095-0312.htm. Accessed June 3, 2010.
4.Cimolai, N. Methicillin-resistant Staphylococcus aureus, public concern, and legislative mandates. Infect Control Hosp Epidemiol 2007;28(7):896.
5.Farr, BM. Political versus epidemiological correctness. Infect Control Hosp Epidemiol 2007;28(5):589593.
6.Harbarth, S, Fankhauser, C, Schrenzel, J, et al.Universal screening for methicillin-resistant Staphylococcus aureus at hospital admission and nosocomial infection in surgical patients. JAMA 2008;299(10):11491157.
7.Huang, SS, Yokoe, DS, Hinrichsen, VL, et al.Impact of routine intensive care unit surveillance cultures and resultant barrier precautions on hospital-wide methicillin-resistant Staphylococcus aureus bacteremia. Clin Infect Dis 2006;43(8):971978.
8.McGinigle, KL, Gourlay, ML, Buchanan, IB. The use of active surveillance cultures in adult intensive care units to reduce methicillin-resistant Staphylococcus aureus-rehted morbidity, mortality, and costs: a systematic review. Clin Infect Dis 2008;46(11):17171725.
9.Robicsek, A, Beaumont, JL, Paule, SM, et al.Universal surveillance for methicillin-resistant Staphylococcus aureus in 3 affiliated hospitals. Ann Intern Med 2008;148(6):409418.
10.Peterson, A, Marquez, P, Terashita, D, Burwell, L, Mascola, L. Hospital methicillin-resistant Staphylococcus aureus active surveillance practices in Los Angeles County: implications of legislation-based infection control, 2008. Am J Infect Control 2010;38(8):653656.
11.Association for Professionals in Infection Control and Epidemiology. MRSA laws and pending legislation—2010. http://www.apic.org/downloads/legislation/MRSA_map.gif. Accessed June 3, 2010.
12.Sinkowitz-Cochran, RL, Garcia-Williams, A, Hackbarth, A, et al. Factors associated with successful implementation of quality improvement efforts: the IHI 100,000 Lives campaign. Paper presented at: Fifth Decennial International Conference on Healthcare-Associated Infections, March 20, 2010; Atlanta.
13.Morgan, DJ, Diekema, DJ, Sepkowitz, K, Perencevich, EN. Adverse outcomes associated with contact precautions: a review of the literature. Am J Infect Control 2009;37(2):8593.
14.Cohen, E, Austin, J, Weinstein, M, Madow, A, Redelmeier, DA. Care of children isolated for infection control: a prospective observational cohort study. Pediatrics 2008;122(2):e411e415.
15.Lewis, AM, Gammon, J, Hosein, I. The pros and cons of isolation and containment. J Hosp Infect 1999;43(1): 1923.
16.Ward, D. Infection control: reducing the psychological effects of isolation. Br J Nurs 2000;9(3):162170.

Hospital Staff Perceptions of a Legislative Mandate for Methicillin-Resistant Staphylococcus aureus Screening

  • Matthew E. Wise (a1), Stephen G. Weber (a2), Amy Schneider (a1), Meg Stojcevski (a2), Anne Marie France (a3), Melissa K. Schaefer (a1), Michael Y. Lin (a4), Alexander J. Kallen (a1) and Ronda L. Cochran (a1)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed