1. Coombs, Emily BSN, RN

Article Content


To determine methicillin-resistant Staphylococcus aureus (MRSA) prevalence and reduce hospital-acquired MRSA rates in one small community hospital through the implementation of aggressive control strategies and to highlight the role of the CNS in implementing evidence-based care and improving outcomes through student involvement in this project.



Infection with MRSA has been shown to be associated with higher mortality rates, increased length of stay, and higher healthcare costs.



Since colonized patients are a major source of MRSA transmission in hospitals, the Institute for Healthcare Improvement recommends routine screening for all patients admitted to a hospital unit with a vulnerable population (eg, ICU) or in units known to have a high prevalence of drug-resistant organisms.



Routine screening, using the traditional method, of all patients admitted to the intensive care unit began in August 2008. Patients who test positive are placed in contact isolation until hospital discharge. Major activities for student involvement include advocating for evidence-based practice regarding MRSA control and prevention within the organization; protocol development; staff, patient, and family education regarding new protocol; compliance monitoring; data collection; and data analysis.



To date, approximately 10% of patients have been identified as colonized or infected with MRSA on admission to the intensive care unit. In addition, one patient who was MRSA negative on admission developed an active MRSA infection prior to discharge. These results highlighted the necessity for the purchase and use of rapid screening laboratory equipment which will decrease the time to result from days to hours and allow for timelier implementation of contact precautions for those infected/colonized. Rapid screening will begin in February 2008 and the protocol will be expanded to include other hospital departments with vulnerable populations.



The preliminary results of this ongoing clinical improvement project suggest that without the use of active surveillance, many MRSA colonized/infected patients may be missed, placing other medically vulnerable patients at risk for exposure to this prevalent microorganism.


Implications for Practice:

Student involvement in this project is an example of how a CNS can work within the three spheres of influence to improve patient care and promote evidence-based practice related to MRSA control and prevention.


Section Description

The journal is proud to share the student abstracts accepted for poster presentation at the 2009 National Association of Clinical Nurse Specialists Conference. These abstracts are submitted under a separate later deadline and therefore did not appear in the journal with the general abstracts. Congratulations to these CNS students and their faculty mentors.