While multidrug-resistant organisms (MDROs) such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci (VRE), Clostridium difficile (C. diff) and certain Gram-negative bacilli (GNB ) continue to alarm the general public and are frequently misunderstood by patients, now there’s an even better reason for healthcare professionals to not become complacent about these pathogens.
This year, a new hospital requirement related to preventing healthcare-associated infections (HAIs) due to MDROs) was added to the Joint Commission’s National Patient Safety Goal 7, “Reduce the risk of HAIs.” This new requirement (as with two other requirements added to this goal relating to surgical site infections and catheter-related bloodstream infections) has a one-year phase-in period that includes defined milestones, with full implementation expected by Jan. 1, 2010. For the new requirement, "implement evidence-based practices to prevent HAIs due to MDROs in acute-care hospitals," Stoessel and Truscott (2009) explain that elements of performance for the hospital include:
-- Conduct periodic risk assessments for MDRO acquisition and transmission
-- Based on the results of the risk assessment, educate staff and licensed independent practitioners about HAIs, MDROs, and prevention strategies at hire and annually thereafter
-- Educate patients, and their families as needed, who are infected or colonized with a MDRO about HAI prevention strategies
-- Implement a surveillance program for MDROs based on the risk assessment
-- Measure and monitor MDRO prevention processes and outcomes
-- Provide MDRO surveillance data to key stakeholders (e.g., leaders, licensed independent practitioners, nursing staff, other clinicians)
-- Implement policies and practices aimed at reducing the risk of transmitting MDROs that meet regulatory requirements and are aligned with evidence-based standards
-- Implement a laboratory-based alert system (manual and/or electronic) that identifies new patients with MDROs, especially when indicated by risk assessment
A quick review of the clinical aspects, routes of transmission and preventive measures of MDROs is in order.
