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Impact of a Mandatory Infection Control Education Program on Nosocomial Acquisition of Methicillin-Resistant Staphylococcus aureus

Published online by Cambridge University Press:  02 January 2015

Todd C. Lee
Affiliation:
University of Toronto, Toronto, Ontario, Canada
Christine Moore
Affiliation:
Mount Sinai Hospital, Toronto, Ontario, Canada
Janet M. Raboud
Affiliation:
University of Toronto, Toronto, Ontario, Canada University Health Network, Toronto, Ontario, Canada
Matthew P. Muller
Affiliation:
University of Toronto, Toronto, Ontario, Canada
Karen Green
Affiliation:
Mount Sinai Hospital, Toronto, Ontario, Canada
Agnes Tong
Affiliation:
University of Toronto, Toronto, Ontario, Canada Mount Sinai Hospital, Toronto, Ontario, Canada
Jastej Dhaliwal
Affiliation:
University of Toronto, Toronto, Ontario, Canada
Allison McGeer*
Affiliation:
University of Toronto, Toronto, Ontario, Canada Mount Sinai Hospital, Toronto, Ontario, Canada
*
Mount Sinai Hospital, 600 University Avenue, Room 210, Toronto, ON, CanadaM5G1X5 (amcgeer@mtsinai.on.ca)

Abstract

Objective.

To assess the impact of an institution-wide infection control education program on the rate of transmission of methicillin-resistant Staphylococcus aureus (MRSA).

Design.

Before-and-after study.

Setting.

A 472-bed, urban, university-affiliated hospital.

Intervention.

During the period March-May 2004, all hospital staff completed a mandatory infection control education program, including the receipt of hospital-specific MRSA data and case-based practice with additional precautions.

Outcome Measure.

The rate of nosocomial MRSA acquisition was calculated as the number of cases of nosocomial MRSA acquisition per 100 days that a person with MRSA colonization or infection detected at admission is present in the hospital (“admission MRSA” exposure-days) for 3 time periods: June 2002-February 2003 (before the Toronto outbreak of severe acute respiratory syndrome [SARS]), June 2003-February 2004 (after the outbreak of SARS), and June 2004-February 2005 (after education). A case of nosocomial acquisition of MRSA colonization or infection represented a patient first identified as colonized or infected more than 72 hours after admission or at admission after a previous hospitalization.

Results.

The rate of nosocomial acquisition of MRSA colonization or infection was 8.8 cases per 100 admission MRSA exposure-days for the period before SARS, 3.8 cases per 100 admission MRSA exposure-days for the period after SARS (P < .001 for before SARS vs after SARS), and 1.9 cases per 100 admission MRSA exposure-days for the period after education (P = .02 for after education vs before education). The volume of alcohol-based handrub purchased was apparently stable, with 4,010 L during fiscal year 2003-2004 (April 2003-March 2004) compared with 3,780 L during fiscal year 2004—2005. The observed rate of compliance with hand washing did not change significantly (40.9% during education vs 44.2% after education; P = .23). The total number of patients screened for MRSA colonization was not different in the 3 periods.

Conclusions.

The rate of nosocomial acquisition of MRSA colonization or infection decreased after SARS and was further reduced in association with a hospital-wide education program.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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