The value of the infection prevention and control nurse led MRSA ward round

Mark I Garvey,Martyn A C Wilkinson,Elisabeth Holden,Kerry L Holden,Victoria Clewer,Craig W Bradley

doi:10.1186/s13756-019-0506-6

Abstract

Meticillin-resistant S. aureus (MRSA) is prevalent in most parts of the world. The study took place at Queen Elizabeth Hospital Birmingham (QEHB) a UK tertiary referral hospital. At QEHB innovative nurse led daily ward rounds for patients that acquire hospital acquired MRSA during their hospital stay are undertaken. The aim is to optimise care delivered for these patients whilst at QEHB, thereby reducing the risk of infection in patients with healthcare-acquired MRSA. A segmented Poisson regression model suggests that the MRSA bacteraemia rate was affected where an 88.94% reduction (p = 0.0561) in bacteraemias was seen by the introduction of these ward rounds. We describe a nurse led MRSA ward round which was associated with a lower rate of MRSA bacteraemias.

Highlights

Staphylococcus aureus is a major cause of healthcare-associated infection worldwide [1,2,3]
Meticillin-resistant S. aureus (MRSA) acquisitions and bacteraemias The optimum segmented Poisson models selected contained terms for a change in the level of acquisitions and bacteraemias, but no trend terms; the models suggest that the number of MRSA acquisitions and bacteraemias were immediately affected by the introduction of the MRSA acquisition nurse led ward round (Fig. 1a and b)
The model demonstrates for MRSA bacteraemias, there was a reduction in mean from 0.805 per 100,000 bed days between May 2016 – December 2016, to 0.089 per 100,000 bed days between January 2017 – November 2018 (Fig. 1b)

Summary

Introduction

Staphylococcus aureus is a major cause of healthcare-associated infection worldwide [1,2,3]. Despite its decline in incidence in several European countries, MRSA infection remains a major cause of avoidable morbidity and mortality in patients admitted to hospital [1,2,3]. It results in increased length of hospital stay, risk of death and treatment costs, with colonised and infected patients acting as reservoirs for the spread of MRSA within hospitals [1,2,3]. Universal decolonisation was reintroduced into the ICU resulting in a reduction of MRSA bacteraemias and acquisitions across QEHB [2].

Methods

Results

Discussion

Conclusion