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Positive Deviance proven to lower MRSA rates

The Robert Wood Johnson Foundation and Plexus Institute today announced the results of a Positive Deviance program, trialed to see the effects it had on MRSA rates. The story caught my eye because I’ve written a couple of stories about Positive Deviance for Briefings on Patient Safety in 2007 and 2008, and the idea always struck me as something so simple, yet so empowering. Positive Deviance solicits ideas for solving a problem from those who deal with that problem often and may think of a solution that might be considered “out of the norm,” but one that works. It’s an approach that attempts to gather behavioral change from those frontline workers who solve problems with the same resources as their peers.

Using Positive Deviance to lower MRSA rates has succeeded, as it was announced at the annual scientific meeting of the Society for Healthcare Epidemiology of America this past weekend. The study began in 2006 and introduced the idea of Positive Deviance into three hospitals from different parts of the country. Each hospital was to use Positive Deviance to help carry out the following three actions:

  • screening all patients admitted to a pilot unit for MRSA
  • isolating all patients who tested positive
  • rigorously adhering to hand hygiene and contact precautions

A team from the Centers for Disease Control and Prevention analyzed the data from these facilities to show a reduction in MRSA rates between 26 and 62%.

This video clip from CBS News shows how one transporter helped his hospital adhere to hygiene and contact precautions (sorry about the commercial before the news).

Could this technique be something your hospital implements? Have you thought of using Positive Deviance for tackling other issues at your facility, not just MRSA?

You can find out more about Positive Deviance by visiting the Positive Deviance Initiative Web site.

And we thought doctors’ ties were dirty

Who knew we should be washing our cell phones? According to a recent study in the Annals of Clinical Macrobiology (reports,  cell phones can–and frequently are–covered in bacteria.

Researchers at Ondokuz Mayis University in Samsun, Turkey tested employee cell phones to discover the following alarming statistic: 94.5 percent of the phones they tested were contaminated with bacteria.

Worse yet–some of these phones were contaminated with drug-resistant “superbugs.”

We’ve known for a while now that certain everyday objects that are not washed or cleaned every day–lab coats and ties, for example–can house bacteria  and help it move around the hospital. But how many hospitals are screening cell phones? Is yours? If so, how do you screen phones? What sorts of policies do you have in place to maintain this practice?

MRSA: Not just for hospitals anymore

Not that this is news, per se–but hospitals have been receiving the bulk of MRSA-related press lately. Here’s an unusual bit of news related to the superbug:

While hospitals receive the bulk of attention in the battle to prevent methicillin resistant Staphylococcus aureus (MRSA), the “superbug” can arise in unexpected places-and recently, that unexpected place was the San Diego Zoo, the LA Times reports.

As many as 20 human caretakers were infected at the zoo. The most likely cause appears to be the first known transmission of MRSA from a zoo animal to a human. It appears that a human handler infected a baby elephant, which was being hand-raised by zookeepers because the mother elephant was unable to care for it. The calf then in turn passed the infection back to other zookeepers.

More than a third of the workers involved in caring for the calf were infected with MRSA, developing for the most part mild symptoms.

If you’re interested in reading the full Times article, it can be found here.

APIC releases goals for “Targeting Zero” in 2009

The Association for Professionals in Infection Control and Epidemiology released their goals for 2009 concerning their Targeting Zero initiativetoday . The details can be found here, but they plan to release elimination guides for ventilator-associated pneumonia, catheter-associated bloodstream infections, MRSA in long-term care settings, and Acinetobacter baumannii.

You may recall APIC’s groundbreaking MRSA Prevalance study released in 2007 that was one of the first studies to show how rampant MRSA is in our hospitals and healthcare system. Since that time, multiple drug resistant organisms have been a focal point for both The Joint Commission (prevention of MDROs recently became part of National Patient Safety Goal # 7, and CMS added prevention of healthcare acquired infections to their no-pay conditions).

So, what are your facilities doing specifically to target the prevention of MRSA spread? Any creative programs?

Kentucky organizations work to fight MRSA

Hello, everyone. I just wanted to pass along a news brief published today in Accreditation Connection about a pair of initiatives in Kentucky, including a MRSA-prevention program. We’ll be talking with some of the folks involved in building the program in the upcoming issue of Briefings on The Joint Commission–it’s an interesting endeavor and I’ll post a preview of the article exclusive to the AHAP Blog very soon.

Two new initiatives with very different approaches have targeted hospital-associated infections in Kentucky, the Courier-Journal reports.

Currently, legislation before the Kentucky General Assembly calls for screening for infections, as well as better control of infections resistant to antibiotics. The bill (House Bill 67) also calls for public reporting of infection rates.

Meanwhile, a collaborative created by the Kentucky Hospital Association and other organizations, targets methicillin-resistant Staphylococcus aureus (MRSA). The collaborative has designed a toolkit with guidelines, sample policies, and other tools for MRSA prevention.

For more information, click here.