Study Suggests Implementation of a VA MRSA Quality Improvement Initiative Improves Knowledge and Perceptions Regarding MRSA Prevention
Infections due to methicillin-resistant Staphylococcus aureus (MRSA) are a large and growing clinical and public health problem in the U.S, resulting in an estimated 2.7 million excess hospital days and $9.5 billion in healthcare costs each year. Without effective preventive strategies, these types of infections are expected to increase given the rapid increase in MRSA colonization detected over the past decade. In the fall of 2006, VA initiated an organized MRSA prevention initiative at 17 VAMCs. This study assessed the effect of this initiative on changes in employee knowledge, attitudes, and practices. Investigators analyzed data from two cross-sectional, anonymous surveys that were distributed at baseline (October 2006) and follow-up (July 2007) at the 17 participating VAMCs. Surveys were completed by 1362 employees at baseline and 952 at follow-up. Respondents included physicians (9%), nurses (38%), allied health professionals (30%), and other support staff (24%).
Results show that implementation of the initiative was associated with temporal improvements in knowledge and perceptions regarding MRSA prevention. Between baseline and follow-up, there were increases in the number of respondents who: correctly identified that alcohol-based hand rub is more effective at inactivating MRSA than soap and water, reported cleaning their hands when entering and exiting a patient room in the past 30 days, reported using alcohol-based hand rub over soap and water when cleaning their hands, and felt comfortable reminding others about proper hand hygiene. These improvements in intermediate outcomes hold promise for the prevention of MRSA transmission and infection, as other healthcare facilities implement similar QI initiatives. Authors suggest that educational programs should continue to focus on increasing staff knowledge regarding the effectiveness of alcohol-based hand rub, and stress that it requires less time than hand-washing and causes less skin irritation than soap and water.
Burkitt K, Sinkowitz-Cochran R, Obrosky D, et al. Survey of employee knowledge and attitudes before and after a multi-center VA quality improvement initiative to reduce nosocomial MRSA infections. American Journal of Infection Control February 3 2010; E-pub ahead of print.
This study was funded by VA. Drs. Burkitt and Obrosky are part of HSR&D's Center for Health Equity Research and Promotion in Pittsburgh, PA.
