In the battle against healthcare-associated infections, Methicillin-Resistant Staphylococcus Aureus (MRSA) appears to be most common compared to others like ESBL, VRE, and CPE. MRSA is a significant concern in healthcare settings, challenging medical professionals and hospitals to implement robust prevention strategies.
Below are ten proven methods that healthcare facilities can adopt to combat MRSA effectively and protect patients and staff.
Table of Contents
- 1 1. Hand Hygiene: The Cornerstone of MRSA Prevention
- 2 2. Active Surveillance Testing (AST)
- 3 3. Contact Precautions and Isolation Policies
- 4 4. Environmental Decontamination
- 5 5. Decolonization Strategies
- 6 6. Antibiotic Stewardship
- 7 7. Universal Gown and Glove Use
- 8 8. Staff Training and Education
- 9 9. Patient and Family Education
- 10
- 11 10. Audit and Feedback Systems
1. Hand Hygiene: The Cornerstone of MRSA Prevention
Hand hygiene remains the most fundamental and effective measure in preventing MRSA transmission. Healthcare workers practice thorough hand washing with soap and water or use alcohol-based hand sanitisers before and after patient contact. Implementing hand hygiene compliance programs and regular audits can significantly reduce MRSA spread.
There is no excuse not to keep to this unless laziness or perhaps lack of water supply to a healthcare setting
2. Active Surveillance Testing (AST)
Active Surveillance Testing is very important in identifying MRSA carriers, allowing for targeted interventions. Healthcare facilities should implement screening protocols for both patients and staff, particularly in high-risk areas such as intensive care units. Early detection through AST enables prompt isolation and decolonization measures, reducing the risk of MRSA transmission.
This is where many hospitals in developing countries find it difficult for lots of reasons
3. Contact Precautions and Isolation Policies
Implementing strict contact precautions is essential when dealing with MRSA-positive patients. This includes:
- Using personal protective equipment (PPE) such as gloves and gowns
- Isolating MRSA-positive patients in single rooms or cohorting them with other MRSA patients
- Limiting patient movement within the facility
These measures significantly reduce the risk of MRSA spread through direct contact.
But then, there must be capacity to do this. This is not usually an issue in developed countries compared to underdeveloped ones.
4. Environmental Decontamination
MRSA can survive on surfaces for extended periods, making thorough environmental cleaning crucial. Healthcare facilities should:
- Implement rigorous cleaning protocols for all patient care areas
- Use effective disinfectants against MRSA
- Pay special attention to high-touch surfaces such as bed rails, doorknobs, and medical equipment
Regular environmental decontamination reduces MRSA reservoirs and minimizes the risk of transmission.
Nevertheless, this will not be possible in resource-limited settings, from my experience.
5. Decolonization Strategies
5.1 Daily Chlorhexidine Bathing
Daily bathing with chlorhexidine gluconate (CHG) has shown significant efficacy in reducing skin contamination and preventing MRSA transmission. This practice is particularly beneficial in high-risk units such as ICUs and surgical wards in MRSA prevention.
5.2 Nasal Decolonization with Mupirocin
The nares (nostrils) are a common site for MRSA colonization. Applying mupirocin ointment to the nasal passages of MRSA-positive patients or high-risk individuals can effectively eradicate nasal carriage and reduce the risk of subsequent infection.
However, Mupirocin is not randomly given to MRSA-positive patients before susceptibility tests in the lab.
6. Antibiotic Stewardship
Responsible antibiotic use is essential in combating antibiotic-resistant bacteria like MRSA. Healthcare facilities usually implement antibiotic stewardship programs that:
- Promote appropriate antibiotic selection and dosing
- Limit unnecessary antibiotic use
- Educate healthcare providers on best practices for antibiotic prescribing
These efforts help reduce the selective pressure that contributes to antibiotic resistance.
This is unachievable where antibiotics use is abused in the community.
7. Universal Gown and Glove Use
Implementing universal gown and glove use for all patient encounters in high-risk areas such as ICUs can significantly reduce MRSA transmission. This approach eliminates the need to identify MRSA-positive patients before taking precautions and provides an additional layer of protection for both patients and healthcare workers.
If you are not a healthcare worker, COVID-19 protocols would have shown you how infection spreading is controlled in a hospital setting.
8. Staff Training and Education
Ongoing education and training for healthcare personnel are essential for effective MRSA prevention. Training programs should cover:
- Proper hand hygiene techniques
- Correct use of PPE
- MRSA transmission routes and prevention strategies
- Importance of adherence to infection control protocols
Regular refresher courses and updates on new guidelines ensure that staff remain vigilant and informed.
I have mandatory infection control training every year, which keeps me abreast of infection control measures. If your facility does not have this, it should implement it.
9. Patient and Family Education
Involving patients and their families in MRSA prevention efforts can enhance overall effectiveness. Healthcare facilities should:
- Provide clear, easy-to-understand information about MRSA and its prevention
- Encourage patients and visitors to practice good hand hygiene
- Educate patients on the importance of completing prescribed antibiotic courses
Empowering patients and families with knowledge promotes a culture of shared responsibility in infection control.
Again, this is a challenge in resource-scared areas or countries, unfortunately.
10. Audit and Feedback Systems
Regular audits of MRSA prevention practices are necessary for maintaining high infection control standards. Healthcare facilities:
- Conduct routine compliance checks for hand hygiene, PPE use, and environmental cleaning particularly for MRSA prevention
- Provide timely feedback to staff on their performance
- Use audit results to identify areas for improvement and tailor interventions
Effective audit and feedback systems drive continuous improvement in MRSA prevention efforts.
Imagine a nurse or a doctor who touches a patient without washing his or her hands. That is no compliance practice for MRSA prevention and infection control in general!
To summarize what I have written, MRSA prevention in healthcare settings requires a multi-faceted approach combining rigorous hygiene practices, targeted interventions, and ongoing education. By implementing these ten proven strategies, healthcare facilities can significantly reduce the incidence of MRSA infections, protect vulnerable patients, and maintain a safer healthcare environment. Remember, the key to success lies in consistent application and a commitment to excellence in infection control practices.
