Nationwide VA initiative sharply cuts MRSA rates

Adhering to hand-hygiene protocols was one of four bundled compliance efforts in the VA’s MRSA Prevention Initiative that led to a 36 percent decrease in MRSA rates.

Health care-associated methicillin-resistant Staphylococcus aureus (MRSA) continues to be a challenge for many hospitals, but results of a nationwide initiative by the Department of Veterans Affairs (VA) at 133 of its long-term care facilities found that using a bundled approach to prevention helped to cut overall MRSA rates by 36 percent. The infection rate reduction was achieved despite the fact that admissions with MRSA colonization increased during the 42-month study, which was published in the January issue of the American Journal of Infection Control.

The VA's MRSA Prevention Initiative calls for screening every patient for MRSA, using gowns and gloves when caring for patients colonized or infected with MRSA, following hand-hygiene protocols and an institutional culture change focusing on individual responsibility for infection control. In addition, the VA created the new position of MRSA prevention coordinator at each center. A similar approach showed similar success in reducing MRSA health care-associated infections (HAIs) in acute care hospitals, the study's authors note.

"We previously reported that a MRSA Prevention Initiative was associated with significant decreases in MRSA HAIs in acute care facilities over a 33-month period in a large health care system. Here we show that the initiative also was associated with decreased rates of MRSA HAIs in VA community living centers without a corresponding decrease in MRSA admission prevalence," the authors noted in a release from the Association for Professionals in Infection Control and Epidemiology. "To our knowledge, declines in MRSA HAIs such as this have not been reported in other long-term care settings. Our experience suggests that adherence to a simple bundle of infection prevention and control strategies may be of value in controlling MRSA HAIs in community living centers [CLCs], especially if the program is implemented widely throughout the network of health care venues in which an individual may seek care."

This latter point was emphasized in the AJIC article. The authors noted that: "The VA's experience with MRSA in both acute care and long-term care settings is consistent with the concept that health care networks obtain better results when they cooperate in infection control."

They concluded: "This approach of encompassing all components of a health care system in a single, overarching infection prevention and control strategy may be a factor underlying the documented success associated with the VA's MRSA Prevention Initiative in acute care settings, spinal cord injury units and CLCs."