The best hospital practices for controlling methicillin-resistant Staphylococcus aureus:: On the cutting edge

OBJECTIVE: A performance improvement task force of Rhode Island infection control professionals was created to develop an epidemiologic model of statewide consistent infection control practices that could reduce the spread of methicillin-resistant Staphylococcus aureus (MRSA). DESIGN: This model encompasses screening protocols, isolation techniques, methods of cohorting positive patients, decolonization issues, postexposure follow-up, microbiology procedures, and standardized surveillance methodologies. These "best practice guidelines" include three categories of recommendations that define priority levels based on the availability of scientific data. SETTING: From 1995 through 2000, several Rhode Island hospitals experienced a fivefold increase in nosocomial acquisition of MRSA. PARTICIPANTS: Rhode Island infection control professionals are a highly interactive group in the unique position of sharing patients and ultimately experiencing similar trends and problems. INTERVENTION: The task force collaborated on developing the best hospital infection control practices to prevent and control the spread of MRSA in Rhode Island. RESULTS: The task force met with local infectious disease physicians and representatives from the Rhode Island Department of Health, the Hospital Association of Rhode Island, and Rhode Island Quality Improvement Partners. Discussions identified numerous and diverse MRSA control practices, issues of consensus, and approaches to resolving controversial methods of reducing the spread of MRSA. The guidelines regarding the best hospital practices for controlling MRSA were finalized 8 months later. CONCLUSION: These guidelines were distributed to all chief executive officers of Rhode Island hospitals by the Rhode Island Department of Health in December 2001. They were issued separate and apart from any regulations, with the intent that hospitals will adopt them as best hospital practices in an attempt to control MRSA.