Methicillin-resistant Staphylococcus Aureus (MRSA) is a bacterium that has been used for curing numerous infections in humans which are difficult to treat via other methods. MRSA is most troublesome, in hospitals prisons and the nursing homes, where it affects patients with open wounds and weak immune system. MRSA advances significantly within a span of 24-48 hours after the occurrence of the symptoms and after that becomes resistant to treatment. The available literature consists of majorly of the observational studies which has inadequate controls for secular trends and confounding to back casual inference. Furthermore, there is inadequate evidence on other outcomes of universal MRSA screening, such as morbidity, harms, resource utilization and mortality rate. Hence, in this research proposal, the focus will be to incorporate the design features and also analytic strategies incorporating secular trends and confounding in MRSA screening. The design will give room for assessment of infection control interventions that will adequately aIDress the outcomes such as morbidity, mortality and harms and also resource utilization.
The John Hopkins Nursing Evidence-Based Practice Model (JHNEBP) shows three important pillars that form the basis for professional nursing. These pillars are practice, education, and research. Practice refers to the nursing standards that the practitioner is required to abide within disseminating their duties. The American nurses association has identified six standards. Education refers to the basic nursing education at the undergraduate level, which steadily advanced through masters and doctorate. This education also includes the seminars and workshops. According to Hopkins, Nursing research should use the EBP approach fostered towards improving patient care and patient outcomes. The idea is backed by the fact that, with more than 5 million and practicing in most health care facilities, nurses make the largest number of health professionals. Hence, are therefore the most likely to influence the type quality and the cost of health care provided (Johns Hopkins Medicine, 2012)
The center for disease control and Prevention (CDC) found that nearly 19,000 Americans died in 2005 from MRSA gotten from hospitals and other health centers. Better Screening of the patients will prove to be very effective since research has revealed that health workers can still get infected by coming into contact with surfaces touched by a patient suffering from MRSA. The contamination increases the chances of the doctor to patient transmission, through contaminated gloves and also patient to patient transmission via unwashed hands. The screening method usually employed is the use of active surveillance cultures.
Most hospitals in USA have reported below average results regarding the prevalence of MRSA. For example, a Veterans Health Administrations (VHA) in Pennsylvania in 2001 only brought down infections in the surgery unit by 30%. In this case, all the patients admitted to the hospital were subjected to a nasal swab, to screen for MSRA.
The inter-professional team
The recommended infection control membership will include the hospital epidemiologist, one representative from the infection prevention, and the hospital administration. Besides, one representative from the senior physician group, critical care unit, senior physician group, pharmacy, and nursing will be incorporated in the committee.
- Among the hospitalized patients:
- What are the effects of general screening strategy for MRSA when compared to no screening?
- What are the effects of screening the entire population as compared to screening selected patients?
- What are the effects of screening the ICU patients?
- What are the effects of screening surgical patients?
- What are the possible effects of screening high-risk patients?
- What are the effects of expanded screening strategy?
PICOS (Population, Intervention, comparator, outcome, timing and setting)
The population of the study will include all the outpatients and all the inpatients. Besides, one ICU patient, two patients under surgery, and three patients at high risk of MRSA infection will be included in the survey. For the intervention,MRSA screening will be carried out in all the patients in a setting or to specific wards or specific patients. The comparator will be No screening, or only the selected population is screened. For timing, follow up will be implemented for the purposes of intervention. The Settings will be wards & intensive care units (ICUs)
Our survey will focus on the following eight major areas. We will carry out the assessment of MRSA risk, Conduct surveillance programs on MRSA and compliance with the primary infection prevention and control methods. We will also conduct social education to the prone parties, conduct antimicrobial stewardship and lastly enforce the MRSA decolonization strategies.
The total number of MRSA infections that have been reported over the last fifteen years stands at 2,753, for high prevalence and 918 for the medium prevalence. Of these infections, the number averted by MRSA screening was 40% for high-risk prevalence and 57% for medium risk prevalence. Hence as we can see, this is still below average. Owing to the above statistics, we can, therefore, conclude that there is still a need to come up with a better and more effective strategy for dealing with MRSA.
Staphylococcus aureas colonization was found in 12% of tal of 41.66% had MRSA infection (Staphylococcus aureus: Screening for Nasal Carriers in a Community Setting with Special Reference to MRSA, 2014).
The infection control committee will be reviewing the surveillance data and coming up with the intervention plans where needed and also formulation and approval of the infection control policies. The committee will also be in charge of reviewing outbreaks & formulating a response and approving the annual goals and objectives of the infection control program.
The research will concentrate on literature published between 2000 to date because this is the evidence most applicable to the current nursing profession. Our principal search terms will be methicillin-resistant Staphylococcus aureus and prevention & control. We will also search the registry of Cochrane Controlled Trials. Finally, we will search evidence from indexed and electronically searchable conference abstracts.
The retrieved sources will be assessed by three independent reviewers for validity to ascertain their credibility, prior to inclusion in the review. The quantitative papers selected for approval will be assessed using standard critical appraisal instruments and also using the assessment and review of the information package.
We will use the major professional societies such as the Inter Seaver, Warren, & Delaney, 2005).
The representative from the infection preventions unit will collaborate with the microbiology laboratory regarding the notification process for test results for MRSA. Thepreventionist
Evaluation of outcomes
The success of the project will be determined by the percentage of the patients who will test negative of MRSA after the administration of the new MRSA control strategy. The report of the outcome will be presented by the team leader, assisted by a few group members, at regular intervals. There will also be one major reporton the success of the project, which will be presented at the end of the year, with all the group members present.
After the success of the project, it will be extended to the other facilities in the organization. In ensuring that the implementation of the project becomes permanent, a seminar will be conducted to educate the other health practitioners on our findings, and this will ensure that it becomes the culture of our organization.
Dissemination of the findings
To market our project, we will start by internal seminars to educate the other health practitioners who were not involved in the project so that they can adopt it. After that, we will also extend it to the members of the public and the other nearby health facilities.
There exists inadequate evidence on other outcomes of universal MRSA screening, such as morbidity, harms, resource utili inadequate evidence to back the efficiency of MRSA screening on any outcavailable literature consists of majorly of the observational studies, which has inadequate controls for secular trends and confounding to back casual inference. Hence,our project on MRSA screening will incorporate the design features and also analytic strategies incorporating secular trends and confounding. The design will give room for assessment of infection control interventions that will adequately aIDress the outcomes such as morbidity, mortality and harms and also resource utilization.
Dearholt, S., & Dang, D. (2012). Johns Hopkins Nursing Evidence-based Practice: Models and Guidelines. Sigma Theta Tau.
Institute of Medicine (U.S.), In Eden, J., In Levit, L. A., In Berg, A. O., & In Morton, S. C. (2011). Finding what works in health care: Standards for systematic reviews. Washington, DC: National Academies Press.
Liu, C., Bayer, A., Cosgrove, S. E., Daum, R. S., Fridkin, S. K., Gorwitz, R. J., & Chambers, H. F. (2011). Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children.Clinical infectious diseases, ciq146.
Screening for Methicillin-Resistant Staphylococcus Aureus (MRSA) Executive Summary | AHRQ Effective Health Care Program. (2015.). Retrieved from http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productid=1551
Staphylococcus aureus: Screening for Nasal Carriers in a Community Setting with Special Reference to MRSA. (2014). Retrieved from http://www.hindawi.com/journals/scientifica/2014/479048/