Monitoring and feedback of hand hygiene compliance and the impact on facility-acquired methicillin-resistant Staphylococcus aureus.

In 2006, we began monitoring hand hygiene compliance by direct observation. In 2006, with no changes in the methicillin-resistant Staphylococcus aureus (MRSA) control program, a 38% reduction of facility-acquired rates for this organism was realized. These results indicate that focused monitoring of hand hygiene can reduce facility-acquired rates of MRSA.

Impact of implementing a method of feedback and accountability related to contact precautions compliance.

BACKGROUND: In January 2002, Infection control professionals for Spartanburg Regional Healthcare System held a planning retreat focused on patient safety. The main challenge discussed was the control of antibiotic-resistant organisms. Rounds on the patient care units had revealed compliance issues with the current isolation procedures. The team developed a process improvement project coined the Effective Processes in Infection Control Project (EPIC). With a broad challenge of antibiotic resistance, the focus was narrowed to isolation precautions for methicillin-resistant Staphylococcus aureus (MRSA). METHODS: The initial stage of the EPIC project was education, followed by routine unit rounds to monitor compliance. A tool was developed to provide immediate feedback for the nursing units. Summary reports were generated for clinical directors as a method of accountability for unit leadership. Rates for facility-acquired MRSA were monitored and compared with MRSA days at risk. RESULTS: Over a 1-year period of increased accountability, the facility-acquired rate of MRSA decreased by 30%, even though the days at risk increased. The decrease was maintained during year 2. CONCLUSIONS: The results of this project point to the importance of accountability with isolation precautions in the effort to combat the spread of MRSA in the hospital setting.