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Health Services Research & Development

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CREATE: Advancing MRSA Infection Prevention

Director: Eli Perencevich, M.D., M.S.

Principal Investigators:

About the CREATE

Hospital-associated infections (HAI) are a major threat to patient safety. The most significant cause of HAI is methicillin-resistant Staphylococcus aureus (MRSA), which accounts for an estimated 94,000 invasive infections and 19,000 deaths annually in the US. In response to concerns about MRSA, VA has implemented a comprehensive MRSA prevention plan, but despite rigorous adherence, 13% of Veterans are still colonized with MRSA at the time of admission, which is twice the national average. This CREATE will examine a number of approaches to MRSA prevention and eradication within VA.


Partner Offices

Each CREATE works closely with operational partners throughout the VA System. The partners associated with this CREATE include:

  • Lew Radonovich, M.D., Center for Occupational Health and Infection Control (COHIC) in the Office of Public Health
  • Gary Roselle, M.D., VHA National Director of the National Infectious Diseases Service (NIDS)
  • Janet Murphy, M.B.A, Director, VA Midwest Health Care Network (VISN-23)


  • Preventing MRSA Infections: A Virtual Comparative Effectiveness Model
    This project aims to create a VISN-wide model simulating MRSA spread and control, which will allow for the rapid assessment of the comparative effectiveness of different MRSA prevention strategies in individual VA facilities or VISNs.
    (PI: Michael Rubin, M.D., Ph.D.)

  • Building an Optimal Hand Hygiene Bundle: A Mixed Methods Approach
    This project will develop and evaluate an evidence-based hand hygiene improvement bundle by conducting a series of trials to test different combinations of potential hand-hygiene interventions (e.g., signage, pocket hand sanitizers, healthcare worker hand cultures). This project will also identify barriers and facilitators to the different interventions—and develop insight to inform national implementation of the different interventions.
    (PI: Heather Reisinger, Ph.D.)

  • Comparative Safety and Effectiveness of Contact Isolation in VA Community Living Centers (CLCs)
    This project aims to advance the understanding of the optimal approach to infection control in VA CLCs. Investigators will examine side effects (depression, isolation) of contact isolation for MRSA prevention among Veterans in CLCs. Study results are expected to provide the first data on the association between infection control practices and MRSA infection rates in CLCs.
    (PI: Daniel Morgan, M.D., M.S.)

  • Checklist to Prevent MRSA Surgical Site Infections
    As the current VA MRSA Bundle does not include components to prevent surgical site infections (SSI) in Veterans already colonized with MRSA, this project will implement a MRSA prevention checklist and test its effectiveness in a quasi-experimental study with an accompanying process evaluation.
    (PI: Eli Perencevich, M.D., M.S.)

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