Fairview Hospital 29 Lewis Avenue Great Barrington MA

Fairview Hospital 29 Lewis Avenue Great Barrington, MA 01230 Geraldine A. Mc. Quoid RN, MA, MSN Director of Education and Infection Control Protocols for MRSA management in a 25 -bed Federally designated Critical Access Hospital

Collaboration with our local Long Term Care Facilities • Higher susceptibility & communicability of infections • Impact on Hospital census • Industry trends in the diagnosis & treatment of MRSA • Rapid MRSA PCR test – bilateral swab of the anterior nares • • • 24 -hour turn around time VIP Screen {EMR} Point of admission, institute precautions – Bed availability – Private room

LTC Testing of Residents / FVH Admission • • Communication to residents & families 153 patients tested by ICP for reliability 33 patients tested positive for a total rate of 22% Treatment options in LTC – – Do not treat Decolonization with Mupirocin Institute precautions Cohorting of patients • FVH Emergency Room protocol – MRSA PCR Swab on all residents not in our database • Onsite Education to LTC facility staff – – Environmental recommendations Extensive hand hygiene Increased personal protective equipment Ongoing communication

On the Rise • Community Acquired and Hospital Acquired MRSA continue to rise • LTC positive patients were asymptomatic for infection • Colonization often precedes clinical infection with MRSA • Often times deadly to geriatric patients • Decisive Action • CMS recent regulations on reimbursement • Outside influences: CDC – SHEA – NIH Cost of Universal Testing of admissions vs loss of revenue for Hospital Acquired MRSA infection Who will be tested?