This article is more than 5 years old. Information may no longer be current.
Rapid screening for MRSA leads to timely discontinuation, cost savings
Click Here to Manage Email Alerts
Recent data suggest rapid PCR-based screening for the detection of MRSA colonization is a cost-effective means of discontinuing unnecessary precautions and freeing hospital resources.
“A growing body of evidence highlights the negative consequences of [contact precautions], including longer waiting times for hospital bed assignment, decreased provider interactions, potentially more preventable adverse events and dissatisfaction with care, increased risks of inappropriate antibiotic use and potential adverse psychological effects,” the researchers wrote. “These findings suggest that programs to accurately identify patients who are no longer colonized may improve patient care.”
Researchers examined 648 patients admitted to the Massachusetts General Hospital ED from June 2012 through December 2013 with a MRSA-positive isolate detected within the previous 90 days. Nasal swabs were obtained from eligible patients reporting no exposure to antibiotics with activity against MRSA in the previous 48 hours. These were processed using a commercial real-time PCR assay, with those who tested negative (65.1%) discontinued from standard MRSA contact precautions. Mean time from specimen collection to discontinuation among these patients was 16.8 hours.
An analysis weighing the impact of idle beds resulting from discontinuation, screening costs and expected revenues was conducted to determine the cost-effectiveness of the approach. Negative patients had significantly reduced bed use compared with positive patients (P < .001), and the program resulted in an estimated 119 available bed-days. Additional revenues and averted contact precaution expenses exceeded the cost of the program by an estimated range of $58,720 to $112,910, which the researchers said demonstrated evidence for the continued implementation of rapid screening and discontinuation.
“As hospitals grapple with an ever-increasing demand for emergency evaluations, inpatient services and the possible need for surge capacity, efficient use of existing beds is paramount,” the researchers concluded. “We have shown that a targeted program for discontinuation of MRSA [contact precautions] in patients who are no longer colonized is a practical and cost-saving approach.” – by Dave Muoio
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts