Reduction of 4SICU Hospital Acquired Methicillin Resistant Staph Aureus

1. Reduction of 4SICUHospital Acquired Methicillin Resistant Staph Aureus Team Members: Infection Control Department Surgical Intensive Care Unit Staff (4SICU)

2. OPPORTUNITY STATEMENT Reduce number of hospital acquired MRSA colonizations and/or infections in the 4SICU by implementing a screening procedure based on successful practice at other healthcare organizations.

3. SOLUTIONS IMPLEMENTED • Screening of high risk patients upon admission to the unit • Weekly screening

4. Criteria for MRSA screening upon admission • Any new admission to the unit who: • Transfer from rehab facility • Transfer from outside hospital greater than 24 hours after admission • Chronic renal failure patients on hemodialysis or on peritoneal dialysis • Any patient with 3 or more hospitalizations within the past year • NOTE: The patient must be off antibiotics to which MRSA is susceptible i.e. vancomycin, trimethoprim/sulfamethoxazole (Bactrim) or linezolid (Zyvox) for at least 2 days prior to the MRSA screen cultures.

5. Criteria for weekly MRSA screening • If a patient present on the unit meets any of the following • conditions, then a MRSA screen will be performed: • Dialysis patient • Patient has been on a ventilator for greater than 5 days • Patient has been in the hospital for greater than 7 days • NOTE: The patient must be off antibiotics to which MRSA is susceptible i.e. vancomycin, trimethoprim/sulfamethoxazole (Bactrim) or linezolid (Zyvox) for at least 2 days prior to the MRSA screen cultures.

6. After Before

7. RESULTS Reduction of hospital acquired MRSA in the 4SICU from 3.7/1000 patient days to 0.7/1000 patient days. Decrease of 75%

8. Next Steps Expand project in other ICUs ?