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Infection prevention, control policies inadequate to stop MRSA spread
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LONDON — Infection prevention and control practices are clearly present in European hospitals, but it appears as though hospital staff do not always follow these practices, according to a presenter here.
Michael A. Borg, MD, of the University of Malta, and colleagues with the IMPLEMENT group (funded by the European Union) surveyed practices regarding methicillin-resistant Staphylococcus aureus prevention by using an online questionnaire sent to members of European infection prevention and control societies. The surveys collected information about background demographics and MRSA proportions in blood culture isolates.
Surveys were administered between March and October 2011; 223 replies were received from infection prevention and control doctors or nurses across 29 European countries. Of the respondents, 105 hospitals had MRSA proportions of less than 5%, 47 hospitals had MSRA proportions between 5% and 20%, and 71 hospitals had MRSA proportions of more than 20%.
More hospitals in the categories with lower MRSA performed daily surveillance of MRSA incidence and also performed root cause analyses to investigate the origin of the infections. No correlation was observed between MRSA prevalence and hospitals that report policies for insertion and maintenance of peripheral and central venous catheters.
The presence of policies for removal of peripheral cannulae at 72 hours or presence of IV line care teams did not correlate with MRSA prevalence. However, hospitals that performed assessments on the staff’s ability to insert and maintain these lines had significantly lower MRSA proportions.
In addition, only 45.5% of hospitals — even those in the low prevalence group — reported use of central venous catheter care bundles, and only 72.1% of these reported compliance.
“These results highlight a gap between ‘paper and practice’ of infection prevention and control in many European hospitals, particularly evident in high prevalence hospitals,” Borg said during his presentation. “This suggests the need for active and effective infection prevention and control interventions to reduce MRSA bacteremia, especially in high prevalence hospitals.”
Disclosure: Dr. Borg reports no relevant financial disclosures.
Perspective
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Keith S. Kaye
This study demonstrates that guidelines and protocols, without effective, clearly adhered to processes, will not be effective in implementing change. Certainly, guidelines are important, but the effective actions (such as root cause analyses) have to occur for positive change to occur. The fact that so few central venous catheter bundles (less than half of hospitals) were present was very surprising. I wonder how the data looked by country.Click Here to Manage Email Alerts