Evaluation of a protocol to control methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) in a surgical cardiac intensive care unit

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a major health care problem in intensive care units. Purpose. To evaluate how nurses implement the methicillin-resistant S. aureus protocol (MRSAP) in a surgical cardiac intensive care unit (SCICU), and to evaluate the change in MRSA infection rates after implementation of the protocol. Methods. The knowledge of nursing staff and their compliance to the MRSAP were assessed with a survey questionnaire and by conducting observations in the unit. Screening compliance and the reduction in infection rates were investigated using a retrospective records review. Results. There was an 88% (23 respondents) awareness of the MRSAP, but knowledge of the detailed content was variable. The staff were satisfied with the existing standards of infection control in the SCICU (85%, 22), and 64% (142) of the observed nurse-patient contacts complied with routine hygiene measures, such as hand hygiene. Few actual cases of MRSA infection were identified during the study period. Owing to the small number of cases it was not possible to test for the significance of this difference at SCICU level, but a chi-square test on the hospital MRSA cases for the same period demonstrated a highly significant reduction (χ2=6.2×10^-41, df=1, p<0.0001). Conclusions. There was evidence to support efficacy of the MRSAP in the reduction of MRSA infections.