Wednesday, June 6, 2012

Hospital shifts focus from Contact to Standard Precautions for MRSA and VRE: Costs decline and infections decrease

Since local factors can be dominant in infection prevention (e.g. size of hospital, number of ICUs or prevalence of MRSA on admission) it is important to acknowledge that one size doesn't always fit all, as far as use of Contact Precautions for MDRO control. At the 2012 APIC meeting in San Antonio Maureen Hodson, RN CIC, at HealthAlliance Hospital in Massachusetts presented her hospital's experience with shifting towards a stronger emphasis on Standard Precautions and away from Contact Precautions. Contact Precautions were limited to MRSA and VRE patients who present with uncontained secretions and ESBL, MDR-GNR and active C. difficile patients.

When comparing the 4-month intervention period to prior periods, costs for gowns and gloves declined by $20,000 and VRE infections declined while MRSA infections were unchanged (see table below).  It will be nice to see if this can be sustained and what the impact is on ESBL or C. difficile, but this approach makes a lot of sense.


Reference: Hodson et al, oral presentation #117, APIC 2012

4 comments:

  1. Replies
    1. Thanks, Mike! You're a great teacher :o)

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  2. You may be aware of the current discussions between several Ontario hospitals who have abandoned VRE surveillance/contact precautions and the provincial authority. There is quite a neat summary of the literature at this link
    http://www.oahpp.ca/resources/documents/pidac/PIDAC-IPC_VRE%20-%20Evdence-based%20review_ENGLISH_2012-09-03.pdf

    ... and a feisty reply from the hospitals here
    http://www.uhn.ca/for_staff/straighttalk/docs/Response_to_PIDAC_VRE.pdf

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  3. Maureen, I am curious what your hand hygiene compliance rate was before the four month period and during the four month period? Also, how is your hand hygiene data collected? Thanks for the information!

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