MRSA Staffing in the PACU

Abstract

The Nationwide MRSA increase has stressed PACU staffing levels. Safety precautions direct infected patients to be recovered on a 1:1 ratio. When 1:1 staffing is required, fewer nurses are available to PACU patients. This project's purpose was to determine if 1:1 staffing is effective for MRSA colonized patients without infections. A tool was developed to risk stratify MRSA patients who are at higher risk for contagious spread, and require 1:1 staffing. This tool was piloted for five months. Patients with MRSA history were assessed preoperatively. If the risk assessment was 8 or greater, the patient was recovered in PACU on a 1:1 basis. A score of 7 or less deemed the patient a 1:2 ratio. Data from patients recovered on a 1:2 basis was correlated with hospital acquired infections. Sixty nine patients were assessed. 25 patients were recovered on a 1:1 basis, and 44 were recovered on a 1:2 basis. No correlation to hospital acquired infections was identified. In conclusion, the MRSA risk identification tool was found safe, saved $22,000 in staffing costs over the trial, improved staffing ratios, O.R. holding times, and nursing and physician satisfaction. We believe these findings to be applicable to all perianesthesia departments.