Hospitals that cooperate on infection control fare better than hospitals acting alone

An individual hospital's infection control efforts have a ripple effect on the prevalence of a deadly and highly infectious bacterium in hospitals throughout its surrounding region, a multi-center research group led by the University of Pittsburgh demonstrated in a computer simulation-based study.

Methicillin-resistant Staphylococcus aureus, or MRSA, infections are better prevented when hospitals cooperate and coordinate their infection control procedures. Hospitals working alone do not achieve the same level of infection control, according to the results of the study published in the October issue of the journal Health Affairs.

"Unless they are associated financially or legally, hospitals often have their own separate infection control programs and procedures," said Bruce Lee, M.D., M.B.A., director of Pitt's Public Health and Computational and (PHICOR) group. "However, hospitals are rarely isolated islands and instead share patients extensively with other hospitals in their area, which can facilitate the spread of ."

Lee and his colleagues obtained real-world data from all 29 hospitals in , Calif., and developed a computer simulation to assess a procedure called "contact isolation" to limit MRSA transmission. The procedure involves testing all patients for MRSA upon admission to a hospital. When a patient tests positive, must wear gloves and gowns whenever entering that patient's room or interacting with that person.

The simulation explored scenarios in which different combinations of hospitals implemented contact isolation to varying degrees.

"The more that hospitals work together and coordinate infection control efforts, the more they all benefit," said Dr. Lee, also an associate professor of medicine, epidemiology and at Pitt's School of Medicine and Graduate School of Public Health. "For example, doubling the number of hospitals that adopt contact isolation can more than double their improvement in ."

The simulation also found that requiring contact isolation at one hospital not only decreased MRSA at that hospital as expected, but also did so in other nearby hospitals that had not implemented the intervention.

When the simulation was run with all the hospitals in Orange County implementing contact isolation simultaneously with a 75 percent compliance rate, MRSA prevalence decreased an additional 3.85 percent over what the hospitals could have achieved on their own. Long-term acute care facilities fared even better, with a 12.13 percent additional decrease.

The simulation relies extensively on data regarding infection rates, annual admissions, average patient length-of-stay, hospital transfers, readmissions, number of intensive care units and bed capacity at the Orange County hospitals.

MRSA is widely prevalent in U.S. hospitals. In 2006, the MRSA colonization rate, or detection of the bacteria on a patient's skin or soft tissue, was 12 per 1,000 inpatients. In 2010, the rate nearly quadrupled to 41 per 1,000 inpatients despite an overall decrease in the rates of MRSA infection.

The researchers had shown previously that hospitals in Orange County, which has a population of 3 million, are highly interconnected through patient transfers and readmission of patients to different hospitals after an intervening stay at home or elsewhere.

Some hospitals have started cooperating to control hospital-acquired infections. In California, the Safety Net Initiative is building a learning collaborative among California public hospitals to reduce such infections. The Pittsburgh Regional Health Initiative has successfully created a culture of change to improve overall patient safety. Similar programs in Iowa, Michigan, Nebraska, New York, South Dakota and Wisconsin also have successfully reduced -acquired infections.

add to favorites email to friend print save as pdf

Related Stories

Most California hospitals implementing infection control

Mar 17, 2012

(HealthDay) -- Most California hospitals implement some policies to improve infection control for multidrug-resistant organisms (MDRO), primarily methicillin-resistant Staphylococcus aureus (MRSA), but fe ...

Study finds MRSA screening saves hospitals money

Jan 27, 2011

Screening patients in the intensive care unit (ICU) for methicillin-resistant Staphylococcus aureus (MRSA) produces cost savings for the whole hospital, according to a study that used a statistical simulation model published ...

Common themes emerge in hospitals' anti-MRSA efforts

Aug 11, 2011

Researchers from the Indiana University have identified common barriers and strategies for successfully implementing practice changes in Intensive Care Units (ICUs). The study, published in the August issue of Infection Co ...

Recommended for you

Ebola in mind, US colleges screen some students

1 hour ago

University students from West Africa may be subject to extra health checks when they arrive to study in the United States as administrators try to insulate their campuses from the worst Ebola outbreak in ...

Senegal confirms its first case of Ebola (Update)

1 hour ago

A man infected with Ebola traveled to Senegal, becoming the first recorded in this country of an outbreak that has hit four other West African countries and has killed more than 1,500 people, the Ministry ...

WHO: More Ebola cases in past week than any other

2 hours ago

The past week has seen the highest increase of Ebola cases since the outbreak in West Africa began, the World Health Organization said Friday, offering more evidence that the crisis is worsening.

Guidelines presented for diagnosing focal liver lesions

17 hours ago

(HealthDay)—Focal liver lesions (FLLs) are mostly benign, and can be diagnosed based on knowledge of their presentation, associated clinical and laboratory features, and natural history, according to clinical ...

User comments