UMMC UMCH MRSA Response to MDH Recommendations Comments are from UMMC, unless otherwise identified a

1
UMMC / UMCH MRSA Response to MDH
RecommendationsComments are from UMMC, unless
otherwise identified as Fairview System Infection
Control

• Christine Hendrickson
• Director of Infection Control

2
Current Isolation Practices

• Known cases electronically flagged for
  readmission 12 year history
• Contact Precautions with signage
• Glove to enter the room
• PRN Gown with intimate, direct contact
• Monitoring hand hygiene compliance

3
Changes to Isolation

• Gown and glove to enter the room
• UMMC broadly defines HCW vs. MDH/MRSA
• HCW taking care of MRSA patients
• Yes for caregivers and services e.g. PT
• May exempt select personnel, undecided.

4
Annual Risk Assessment

• History of annual risk assessment JC
• New Implement Active Surveillance
• 1st Phase Adult ICUs eval. after 6 mos.
• 2nd Phase Pediatric ICUs eval. 6 mos.
• 3rd Phase Other select units eval 6 mos.

5
Family Isolation Practices

• No change
• Encourage HH before entering the room.
• Require hand hygiene when leaving.
• Follow caregiver practices for direct cares
• Glove, gown and hand hygiene.

6
University of Minnesota Medical CenterUniversity
of Minnesota Childrens HospitalHospital
Acquired MRSA Rate (Number of Patients with
Colonization Infection per 10,000 Patient
Days)2005 - 2007
7
Surveillance

• Following current definitions no change
• Healthcare-associated and hosp. acquired
• By patient care unit, SSI- by each, no rates
• Hospital-assoc. easier to determine clinical
  isolates as infection- exception is wounds,
  sputum.

8
Discontinuation of MRSA

• Staying with current FV policy
• Restrictive of potential candidates
• Off Atb. that impact MRSA for 24hrs.
• Screen on two separate days, 24 hrs. apart
• MDH 3 cultures, 3 weeks apart, is also
  restrictive of candidates.
• Not supportive of decolonization

9
Environment

• Completed evaluation using ATP
• 400 occupied, 210 discharge pt. rooms
• Significantly low counts, of low counts
• Higher bedrail, bathroom door-knob
• Lower keyboard, treatment cart
• Eval. and improve dedicated-equipment

10
Environmental Services

• Enhancing our partnership, teamwork
• Discontinued Quat. cotton rags. neutralizes
  the disinfectant (in buckets)
• Disp. non-cotton wipes/solution or pour cotton
  or micro-fiber wipes.
• TBD Efficacy of micro-fiber wipes

11
Antimicrobial Management Team

• 1 year ago
• Lead by Pharm D., ID Clinical Specialist
• Provide guideline supported recommendations
• Daily rounds to evaluate and collaborate with
  prescribing MDs.

12
Thank You

• Questions?