Evaluation of a protocol to control methicillin resistant Staphylococcus aureus (MRSA) in a surgical cardiac intensive care unit

Abstract

Methicillin Resistant Staphylococcus aureus (MRSA) is a major healthcare problem related to morbidity and mortality in Intensive Care Units1.
Purpose
To evaluate how nurses implement the Methicillin Resistant Staphylococcus aureus Protocol (MRSAP) in a surgical cardiac intensive care unit (SCICU), and to evaluate the change in MRSA infection rates following the implementation of the protocol.
Methods
The knowledge of nursing staff and their compliance to the MRSAP were assessed using a survey questionnaire and by conducting observations in the unit. Screening compliance and the reduction in infection rates were investigated using a retrospective records review.
Results
There was an 88% (23) awareness of the MRSAP, but knowledge of the detailed content was variable. Staff were satisfied with the existing standards of infection control in SCICU (84.6%, 22) and compliance with routine hygiene measures, such as hand hygiene, equated to 64% (144). Inadequate data in sampled records prevented meaningful analysis of screening compliance. The change in infection rates between pre and post MSAP periods in a SCICU, which incorporated use of infection risk stratification data to demonstrate comparability of the two groups of patients, revealed that despite the high MRSA infection rate in 2005 (1.18%), and subsequent drop post MRSAP (0.35%), the actual number of cases found was too small to test statistically for significant difference. There was also a significant decrease in MRSA infection rates in the hospital for matched periods (p<0.0001).
Conclusions
There was evidence to support the efficacy of the MRSAP in the reduction of MRSA infections.