ISOLATION PRECAUTIONS FOR METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS: ELECTRONIC SURVEILLANCE TO MONITOR ADHERENCE

The Centers for Disease Control and Prevention recently updated guidelines for isolation precautions and added specific recommendations for the management of multidrug-resistant organisms. However, the extent to which these recommendations are followed is unknown. Although the recommendations are based on studies with high internal validity, the effectiveness of these interventions in clinical practice also is unknown. Evidence of the effectiveness of isolation precautions for preventing transmission of infections caused by multidrug-resistant organisms in acute care settings, with methicillin-resistant Staphylococcus aureus as an example, was reviewed. Despite a lack of experimental data, numerous descriptive and correlational studies and a sound theoretical rationale strongly Suggest that barrier precautions play an important role in the prevention of transmission of infections due to multidrug-resistant organisms. Two major problems, however, still exist. First, staff members' adherence to national recommendations on isolation precautions, although insufficiently described, appears to be inadequate. Second, efficient, reproducible methods for ongoing surveillance of practices such as isolation precautions are not readily available. Automated surveillance systems that provide support for making decisions are promising for this purpose, are likely to result in cost savings, and therefore warrant more widespread development, testing, and implementation. (American Journal of Critical Care. 2010;19:16-27)