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Commonalities across hospitals guide MRSA bundle implementation
Welsh CA. Infect Control Hosp Epidemiol. 2011;32:918-921.
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After implementing changes to reduce methicillin-resistant Staphylococcus aureus in intensive care units, researchers from Indiana found five common themes imperative to successful bundle implementation and may serve as a descriptive and systemic model for future initiatives.
“Our research found that while implementation plans should be locally derived, reducing and preventing the spread of infections in ICUs entails overcoming common barriers,” Catherine Amber Welsh, PhD, of the Indiana University Center for Health Services and Outcomes Research, said in a press release.
In 2006, Welsh and colleagues collaborated with five Indianapolis hospitals to implement four evidence-based practices: active surveillance, hand hygiene, patient isolation and the use of personal protective equipment to reduce MRSA transmission and infection in six ICUs.
Six months after implementation, 24 team members were interviewed for an in-depth understanding of the functioning of the bundle approach, perceived effectiveness, challenges and key lessons learned.
Overall, 42 themes were reported, of which five themes were most common among all hospitals and provided successful solutions to commonly encountered issues:
- Engage frontline staff in decision-making and implementation.
- Build the right multidisciplinary team.
- Commit to data collection, management and feedback.
- Acquire and maintain management support.
- Value of process mapping.
“The tendency for any organization unit is to say, ‘We’re different,’ implying that change efforts must be tailor-made for each unique group or culture,” Welsh said in the release. “But our research shows that while units are unique, there are commonalities that can guide consideration and planning efforts to implement new practices. We hope that this study will help hospitals realize that change implementation is both a unique and universal activity.”
Disclosure: This research was funded by the US Agency for Healthcare Research and Quality (contract HHSA2902006000131, under Office of Management and Budget control no. 0935-0168, expiration date Sept. 30, 2012).
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