MRSA, Change and Nursing Leadership

Paper Summary:

In this article, the writer notes that methicillin-resistant staphylococcus aureus (MRSA) is a serious concern for many hospitals. The writer points out that not only are morbidity and mortality rates due to MRSA infection significant, but longer hospital stays, higher costs of treatment and the specter of treatment failure compared to methicillin-sensitive organisms are all realities that are faced. This paper outlines a proposition to implement a hospital-wide change in the hospital's handwashing policy to that utilizing a chlorhexidine-based foam. Budgetary considerations as well as a strategy for implementation and evaluation of effectiveness on MRSA infections after one year of implementation are discussed.

Outline:
Abstract
Introduction
Literature Review
Current Practice
Proposed Practice
Budgetary Considerations
Concerns Regarding Change
Values and Roles
Conclusion

From the Paper:

"In order to improve the rate of infection from 10 cases per year to less than one per year, a new practice will be instituted based on the redundancy principle regarding implementation of handwashing procedures. Similarly redundant handwashing facilities (both handwashing stations and foam chlorhexidine gluconate) conveniently located at strategic locations. This solution will include new dispensers at strategic locations with high personnel traffic such as nurses' stations, patient rooms, specific bedside sites (e.g. in intensive care units, labor and delivery bedsides), communal areas for nurses and physicians and outpatient examination rooms. It is expected to be accomplished within 3 months with a reduction in overall and MRSA nosocomial infections after one year."

Sample of Sources Used:

• Centers for Disease Control [CDC]. (2004). National Nosocomial Infections Surveillance(NNIS) system report, data summary from January 1992 through June 2004. Am J Infect Control, 32,470-85. Retrieved March 13, 2007 from http://www.cdc.gov/ncidod/dhqp/pdf/nnis/2004NNISreport.pdf
• Kampf G, Kramer A. (2004). Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clin Microbiol Rev., 17(4), 863-93. Retrieved March 13, 2007 from http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15489352
• Kopp BJ, Nix DE, Armstrong EP. (2004). Clinical and economic analysis of methicillin-susceptible and -resistant Staphylococcus aureus infections. Ann Pharmacother, 38(9), 1377-82. Retrieved March 13, 2007 from the Pubmed database.
• MedEx01. (n.d.). BD E-Z Scrub(TM) Antimicrobial Hand Pump Foam Solution With 2% CHG. MedEx01.com. Retrieved March 13, 2007 from http://www.medex01.com.
• Pittet D et al. (2000). Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme. Lancet, 356(9238), 1307-12. Retrieved March 13, 2007 from the Pubmed database.

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