A bundled approach to reduce methicillin-resistant Staphylococcus aureus infections in a system of community hospitals

Jonathan B. Perlin, Jason D. Hickok, Edward J. Septimus, Julia A. Moody, Jane D. Englebright, Richard M. Bracken

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)57-68; quiz 68-9
JournalJournal for healthcare quality : official publication of the National Association for Healthcare Quality
Issue number3
StatePublished - May 1 2013

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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