A Statewide Collaborative to Reduce Methicillin-Resistant Staphylococcus aureus Bacteremias in New Mexico

Kellie, Susan; Timmins, Anne; Brown, Carlene

doi:10.1016/s1553-7250(11)37019-5

Cited by 4 publications

(2 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, many hospital infection control efforts focus exclusively on hospitals. Even existing multi-institutional collaboratives tend to exclude nursing homes(35–37). Hospital infection control efforts that do include nursing homes tend to only include a few nursing homes that receive or send a substantial number of direct transfers (e.g., strong fiscal/administrative ties with the hospital).…”

Section: Discussionmentioning

confidence: 99%

The Importance of Nursing Homes in the Spread of Methicillin-resistant Staphylococcus aureus (MRSA) Among Hospitals

et al. 2013

View full text Add to dashboard Cite

Background Hospital infection control strategies and programs may not consider control of methicillin-resistant Staphylococcus aureus (MRSA) in nursing homes in a county. Methods Using our Regional Healthcare Ecosystem Analyst (RHEA), we augmented our existing agent-based model of all hospitals in Orange County (OC), California, by adding all nursing homes and then simulated MRSA outbreaks in various healthcare facilities. Results The addition of nursing homes substantially changed MRSA transmission dynamics throughout the County. The presence of nursing homes substantially potentiated the effects of hospital outbreaks on other hospitals, leading to an average 46.2% (range: 3.3–156.1%) relative increase above and beyond the impact when only hospitals are included for an outbreak in OC’s largest hospital. An outbreak in the largest hospital affected all other hospitals (average 2.1% relative prevalence increase) and the majority (~90%) of nursing homes (average 3.2% relative increase) after six months. An outbreak in the largest nursing home had effects on multiple OC hospitals, increasing MRSA prevalence in directly connected hospitals by an average 0.3% and in hospitals not directly connected via patient transfers by an average 0.1% after six months. A nursing home outbreak also had some effect on MRSA prevalence in other nursing homes. Conclusions Nursing homes, even those not connected by direct patient transfers, may be a vital component of a hospital’s infection control strategy. To achieve effective control, a hospital may want to better understand how regional nursing homes and hospitals are connected via both direct and indirect (with intervening stays at home) patient sharing.

show abstract

Section: Discussionmentioning

confidence: 99%

The Importance of Nursing Homes in the Spread of Methicillin-resistant Staphylococcus aureus (MRSA) Among Hospitals

et al. 2013

View full text Add to dashboard Cite

show abstract

“…These results are not unprecedented, as recent reports have demonstrated similarly successful programs in a variety of environments (Ellingson et al, 2011;Kellie, Timmins, & Brown, 2011). Yet, the ability of this program to bring about performance improvement in a large number of diverse facilities hints at its generalizability to other community hospitals.…”

Section: Implications For Practicementioning

confidence: 63%

A Bundled Approach to Reduce Methicillin-Resistant Staphylococcus aureus Infections in a System of Community Hospitals

Perlin

Hickok

Septimus

et al. 2013

Journal for Healthcare Quality

View full text Add to dashboard Cite

Methicillin-resistant Staphylococcus aureus (MRSA) infections pose a significant challenge to U.S. healthcare facilities, but there has been limited study of initiatives to reduce infection and increase patient safety in community hospitals. To address this need, a multifaceted program for MRSA infection prevention was developed for implementation in 159 acute care facilities. This program featured five distinct tools-active MRSA surveillance of high-risk patients, enhanced barrier precautions, compulsive hand hygiene, disinfection and cleaning, and executive champions and patient empowerment-and was implemented during 1Q-2Q 2007. Postintervention (3Q 2007-2Q 2008), 10.2% of patients with high-risk for infection or complications due to MRSA had nasal colonization. Volume of disposable gown and alcohol-based hand sanitizer use increased substantially following program implementation. Self-reported rates, based on NHSN definitions, of healthcare-associated central line-associated bloodstream infections and ventilator-associated pneumonia due to MRSA decreased 39% (p < .001) and 54% (p < .001), respectively. Infection rates continued to decrease during the follow-up period (1Q-4Q 2009). This sustained improvement demonstrates that reducing healthcare-associated MRSA infections in a large number of diverse facilities is possible and that a "bundled" approach that translates science into clinical and executive performance expectations may aid in overcoming traditional barriers to implementation.

show abstract

The sustainability of new programs and innovations: a review of the empirical literature and recommendations for future research

et al. 2012

View full text Add to dashboard Cite

BackgroundThe introduction of evidence-based programs and practices into healthcare settings has been the subject of an increasing amount of research in recent years. While a number of studies have examined initial implementation efforts, less research has been conducted to determine what happens beyond that point. There is increasing recognition that the extent to which new programs are sustained is influenced by many different factors and that more needs to be known about just what these factors are and how they interact. To understand the current state of the research literature on sustainability, our team took stock of what is currently known in this area and identified areas in which further research would be particularly helpful. This paper reviews the methods that have been used, the types of outcomes that have been measured and reported, findings from studies that reported long-term implementation outcomes, and factors that have been identified as potential influences on the sustained use of new practices, programs, or interventions. We conclude with recommendations and considerations for future research.MethodsTwo coders identified 125 studies on sustainability that met eligibility criteria. An initial coding scheme was developed based on constructs identified in previous literature on implementation. Additional codes were generated deductively. Related constructs among factors were identified by consensus and collapsed under the general categories. Studies that described the extent to which programs or innovations were sustained were also categorized and summarized.ResultsAlthough "sustainability" was the term most commonly used in the literature to refer to what happened after initial implementation, not all the studies that were reviewed actually presented working definitions of the term. Most study designs were retrospective and naturalistic. Approximately half of the studies relied on self-reports to assess sustainability or elements that influence sustainability. Approximately half employed quantitative methodologies, and the remainder employed qualitative or mixed methodologies. Few studies that investigated sustainability outcomes employed rigorous methods of evaluation (e.g., objective evaluation, judgement of implementation quality or fidelity). Among those that did, a small number reported full sustainment or high fidelity. Very little research has examined the extent, nature, or impact of adaptations to the interventions or programs once implemented. Influences on sustainability included organizational context, capacity, processes, and factors related to the new program or practice themselves.ConclusionsClearer definitions and research that is guided by the conceptual literature on sustainability are critical to the development of the research in the area. Further efforts to characterize the phenomenon and the factors that influence it will enhance the quality of future research. Careful consideration must also be given to interactions among influences at multiple levels, as well as issues su...

show abstract

A Statewide Collaborative to Reduce Methicillin-Resistant Staphylococcus aureus Bacteremias in New Mexico

Cited by 4 publications

References 23 publications

The Importance of Nursing Homes in the Spread of Methicillin-resistant Staphylococcus aureus (MRSA) Among Hospitals

The Importance of Nursing Homes in the Spread of Methicillin-resistant Staphylococcus aureus (MRSA) Among Hospitals

A Bundled Approach to Reduce Methicillin-Resistant Staphylococcus aureus Infections in a System of Community Hospitals

The sustainability of new programs and innovations: a review of the empirical literature and recommendations for future research

Contact Info

Product

Resources

About