Admission screening for MRSA gains award

Process uses EMRs, molecular testing

One U.S. health care system is ahead of the curve when it comes to dealing with methicillin-resistant Staphylococcus aureus (MRSA), a difficult-to-treat strain of bacteria that is a significant cause of hospital-acquired infections.

Evanston (IL) Northwestern Healthcare, recently chosen as the 2007 recipient of the Eisenberg Patient Safety and Quality Award, began an admission screening program for MRSA more than two years ago, well before the strain became such a frequent topic in news reports.

The admission surveillance program, begun in 2005, uses the electronic medical record (EMR) and same-day molecular testing to screen patients on admission and determine if they are infected with MRSA or are colonized with the bacteria but not yet infected, explains Lance Peterson, MD, FASCP, epidemiologist and director of clinical microbiology and infectious disease research at Evanston Northwestern and professor of pathology and medicine at Northwestern University's Feinberg School of Medicine.

The process — the first to combine those two technologies in MRSA screening — allows physicians to immediately identify and treat patients who might otherwise be unaware of having MRSA.

That's because the EMR contains an admission sheet as part of each patient's treatment plan that prompts the admitting team to order and collect a nasal swab before a health care provider moves to the next computer screen.

"This electronic 'red flag' ensures compliance and allows us to document cases in which a patient may refuse the test," Peterson says.

Each patient's nasal sample is tested using real-time DNA analysis. Once diagnosed, patients are treated with a nasal antibiotic ointment for five days and also need to bathe with a special antiseptic soap on the first, third, and last day of the nasal ointment treatment.

At its three hospitals, Evanston Northwestern reduced MRSA infection rates by 60% within the first year of the program.

The Eisenberg Award, sponsored by the National Quality Forum (NQF) and The Joint Commission, recognizes Evanston Northwestern for local innovation regarding patient safety.

The health system's MRSA Reduction Program Team planned to publish its findings, and members offer an outreach program to long-term care facilities to help prevent MRSA infection.