The 2 other ICUs in our study, the coronary care unit
and a second medical ICU, did not have protocols for
active surveillance. They used incident surveillance
instead. We defined MRSA acquisition in these 2 units
as any patient with a new culture positive for MRSA at
any site 48 hours after admission.
The ICU physicians in all the study units were informed
of swabs and cultures that were positive for MRSA by a
telephone call from the microbiology laboratory. Patients
went on contact isolation precautions immediately upon
the report of a culture positive for MRSA. Infection prevention
staff
monitored the
MRSA acquisition
rates
and compliance
with admission, weekly, and discharge surveillance
swabs, and they reported the data monthly to the 3 ICUs
in the study that were performing active surveillance.
They also observed hand hygiene compliance monthly
in all ICUs by using “secret shoppers” as data collectors
during both study periods.