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Preventing Transmission of Dangerous Staph Germs

Preventing Transmission of Dangerous Staph Germs

By Sandra Cooley, RN, CIC

 

In spring of 2007, the Ithaca Journal ran an Associated Press article entitled “Dangerous staph germ far more common than thought.” The article summarized the results of a nationwide study conducted by the Association of Professionals in Infection Control and Epidemiology (APIC) on the prevalence of hospital- and health-care-acquired MRSA (methcillin-resistant staphylococcus aureus) infections.

 

MRSA is a type of bacteria that causes “staph” infections that are resistant to certain commonly prescribed antibiotics. These infections can have serious implications in the hospital setting, where patients have undergone surgery or have compromised immune systems due to illness. The study concluded that the national rate for MRSA infection and colonization is 46 per 1,000 inpatients, which is eight to eleven times higher than previously estimated.

 

MRSA infections have been a growing concern in the health-care setting. In the 1970s, when MRSA was first recorded, these antibiotic-resistant infections represented two percent of all hospital-acquired infections (HAI). In 2006, MRSA represented 63 percent of all HAI, according to the Centers for Disease Control and Prevention (CDC).

 

Cayuga Medical Center’s current rates of MRSA are very low and most are cases of colonized, not infected, patients. Colonized means the bacteria are present but the person is not sick with an MRSA infection. In 2006, of the 8,037 inpatients treated at Cayuga Medical Center, we had three cases of hospital-acquired MRSA. This is significantly lower than the rate of 46 cases per 1,000 inpatients released in APIC’s nationwide study.

 

How is Cayuga Medical Center responding to this growing concern?

 

Cayuga Medical Center was designated in 2005 as a benchmark hospital for appropriate antibiotic use in the category of Community Teaching Hospitals. With the increasing development of antibiotic-resistant bacteria, the CDC has made the appropriate use of antibiotics a national priority. Because our doctors use antibiotics judiciously, we are not contributing to the development of “super-bugs” such as MRSA. In addition, we will soon be participating in a pilot program of the National Healthcare Safety Network, which until now has only been open to large hospitals. By participating in this network, we will collect more data comparing us to other hospitals in the state and the country. 

 

How do health-care workers at Cayuga Medical Center prevent MRSA infections?

 

Cayuga Medical Center has a vigorous infection control program based on guidelines from the Healthcare Infection Control and Prevention Advisory Committee (HICPAC) of the CDC. These guidelines and our infection control program place a very strong emphasis on hand hygiene using antimicrobial soaps and alcohol hand sanitizers before and after interacting with each patient. Hand hygiene is critically important in preventing the transmission of bacteria such as MRSA, which are spread through direct contact (most commonly human hands).

 

Every new employee coming to work at the medical center is required to go through infection control training. They learn about standard precautions and attend an annual mandatory infection control refresher course.

 

What other infection control measures do medical center employees take?

 

All of our employees follow “standard universal precautions,” which means that we deal with every patient as if he or she has a communicable disease. We do this by using personal protective equipment, including gloves and gowns, and by following the practices of good hand hygiene. If a patient is diagnosed with a communicable disease, we limit contact by using masks and by following isolation precautions. We are also following APIC recommendations for MRSA transmission and prevention, including APIC’s MRSA risk assessment and surveillance program.

 

What happens when a patient is identified with MRSA?

 

A patient with MRSA may be either infected (sick) or colonized. In either scenario, the potential exists to pass on MRSA through direct contact with other people. When patients are identified with MRSA, they are put on “contact-isolation precautions.” This means that anyone entering their rooms dons a gown and gloves, which are discarded immediately upon leaving the room. In addition, all MRSA patients are flagged in the computer. If they are readmitted to the medical center at a future date, they are placed on contact isolation for the duration of their hospital stay.

 

Does Cayuga Medical Center participate in the Institute for Healthcare Improvements (IHI) Five Million Lives Campaign?

 

Yes, we have been participating in the IHI campaign since the beginning: Cayuga Medical Center has adopted the IHI guidelines to improve care and reduce MRSA and other infections. The IHI recommendations are implemented and carefully tracked as one of our Infection Control Department’s core measurements for monitoring performance improvement in this important area of hospital care.

 

Sandra Cooley is a registered nurse and the Infection Control Practitioner at Cayuga Medical Center. She is certified in infection control and has been practicing in the field for 14 years.

 

 

 

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