The Centers for Disease Control and Prevention, in a Methicillin-resistant Staphylococcus aureus toolkit/presentation, identifies the following 14 core strategies for the prevention of MRSA. Note: The CDC provides a disclaimer in the presentation stating that the findings and conclusions in it are those of the authors and do not necessarily represent the official position of the CDC.
Hand hygiene
1. Hand hygiene should be a cornerstone of prevention efforts
- Prevents transmission of pathogens via hands of healthcare personnel
2. As part of a hand hygiene intervention, consider:
- Ensuring easy access to soap and water/alcohol-based hand gels
- Education for healthcare personnel and patients
- Observation of practices - particularly around high-risk procedures (before and after contact with colonized or infected patients)
- Feedback — "Just in time" feedback if failure to perform hand hygiene observed
Contact precautions
3. Involves use of gown and gloves for patient care
- Don equipment prior to room entry
- Remove prior to room exit
4. Single room (preferred) or cohorting for MRSA colonized/infected patients.
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5. Use of dedicated non-essential items may help decrease transmission due to contact with these fomites.
- Blood pressure cuffs
- Stethoscopes
- IV poles and pumps
Recognizing previously colonized
6. Patients can be colonized with MRSA for months.
7. There is no single 'best' strategy for discontinuation of isolation precautions for MRSA patients.
8. Being able to recognize previously colonized or infected patients who have not met criteria for discontinuing isolation allows them to be subject to interventions in a timely fashion.
Laboratory reporting
9. Facilities should have a mechanism for rapidly communicating positive MRSA results from laboratory to clinical area.
10. Allows for rapid institution of interventions on newly identified MRSA patients.
Education
11. To improve adherence to hand hygiene.
12. To improve adherence to interventions (e.g., contact precautions).
13. Encourage behavioral change through a better understanding of the problem.
Device and procedure-associated prevention measures
14. In addition to measures designed to prevent MRSA transmission, healthcare facilities should routinely implement strategies for preventing device- and procedure-associated infections
- Central line-associated bloodstream infections
- Surgical site infections
- Catheter-associated urinary tract infections
- Ventilator-associated pneumonia
Source: CDC.
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