2.50
Hdl Handle:
http://hdl.handle.net/10755/158925
Type:
Presentation
Title:
Active Surveillance of MRSA in a Special Care Nursery: Costs and Health Outcomes
Abstract:
Active Surveillance of MRSA in a Special Care Nursery: Costs and Health Outcomes
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2010
Author:Vonderheid, Susan, PhD, RN
P.I. Institution Name:Univ. of IL
Contact Address:845 S. Damen Avenue, Chicago, IL, 60612, USA
Contact Telephone:312-996-7982
Co-Authors:S. Vonderheid, B. McFarlin, , University of Illinois, Chicago, IL; R. Garcia, C. Jang, M. Djonlich, J. Maghirang, , St. Joseph Hospital, Chicago, IL;
Backgroud/Problem: Methicillin-resistant Staphylococcus aureus (MRSA) is the most common antimicrobial-resistant pathogen causing hospital acquired infections in the U.S. and the rate of MRSA continues to rise. In 2007, Illinois passed a legislative mandate requiring active surveillance cultures to screen for MRSA in hospital intensive care units. However, professional guidelines do not support routine active surveillance cultures and funding to cover screening costs were not included. There is a need to understand the costs and infant health-related outcomes of MRSA screenings in the Special Care Nursery at our community hospital. Despite a low rate of positive MRSA cultures (1 out of 1181 infants), and the increased use of resources (staffing, lab, supplies) to implement mandatory screening despite no reimbursement, the costs of mandatory screening might outweigh the benefits. Purpose: The purpose of the study is two fold: 1) to prospectively examine the personnel and supply costs associated with the mandated MRSA screening; and 2) to retrospectively examine the infant outcomes and costs associated with implementing MRSA screening in a special care nursery. Framework: Donabedian's Quality of Care Model. Sample: Personnel: 45 observations of staff members. Infants: 413 infants admitted in 2008. Methods: Observations of staff during MRSA screenings (time and motion study) and data abstraction from: the infant log book, infant medical records, and SCN financial reports. Descriptive analyses were conducted. Results: Mandatory screening lead to increased costs, problems related to false-positives, and unintended consequences (e.g.,initiation of antibiotics for non-MRSA organisms, increased liability for non-treatment of asymptomatic patients with non-MRSA organisms). Implications: More evidence is required to determine the effectiveness of universal active MRSA screening at reducing MRSA rates across hospital settings, and whether it is cost-effective. Our findings suggest that universal screening might not be warranted when there is a rare incidence of positive MRSA cultures.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleActive Surveillance of MRSA in a Special Care Nursery: Costs and Health Outcomesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158925-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Active Surveillance of MRSA in a Special Care Nursery: Costs and Health Outcomes</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Vonderheid, Susan, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Univ. of IL</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">845 S. Damen Avenue, Chicago, IL, 60612, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">312-996-7982</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">vonde@uic.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">S. Vonderheid, B. McFarlin, , University of Illinois, Chicago, IL; R. Garcia, C. Jang, M. Djonlich, J. Maghirang, , St. Joseph Hospital, Chicago, IL;</td></tr><tr><td colspan="2" class="item-abstract">Backgroud/Problem: Methicillin-resistant Staphylococcus aureus (MRSA) is the most common antimicrobial-resistant pathogen causing hospital acquired infections in the U.S. and the rate of MRSA continues to rise. In 2007, Illinois passed a legislative mandate requiring active surveillance cultures to screen for MRSA in hospital intensive care units. However, professional guidelines do not support routine active surveillance cultures and funding to cover screening costs were not included. There is a need to understand the costs and infant health-related outcomes of MRSA screenings in the Special Care Nursery at our community hospital. Despite a low rate of positive MRSA cultures (1 out of 1181 infants), and the increased use of resources (staffing, lab, supplies) to implement mandatory screening despite no reimbursement, the costs of mandatory screening might outweigh the benefits. Purpose: The purpose of the study is two fold: 1) to prospectively examine the personnel and supply costs associated with the mandated MRSA screening; and 2) to retrospectively examine the infant outcomes and costs associated with implementing MRSA screening in a special care nursery. Framework: Donabedian's Quality of Care Model. Sample: Personnel: 45 observations of staff members. Infants: 413 infants admitted in 2008. Methods: Observations of staff during MRSA screenings (time and motion study) and data abstraction from: the infant log book, infant medical records, and SCN financial reports. Descriptive analyses were conducted. Results: Mandatory screening lead to increased costs, problems related to false-positives, and unintended consequences (e.g.,initiation of antibiotics for non-MRSA organisms, increased liability for non-treatment of asymptomatic patients with non-MRSA organisms). Implications: More evidence is required to determine the effectiveness of universal active MRSA screening at reducing MRSA rates across hospital settings, and whether it is cost-effective. Our findings suggest that universal screening might not be warranted when there is a rare incidence of positive MRSA cultures.</td></tr></table>en_GB
dc.date.available2011-10-26T21:31:52Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T21:31:52Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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