Legislation Would Require Hospital-Wide Plan to Prevent MRSA Within 30 Days of Enactment
TRENTON – Senate Majority Leader Barbara Buono and Senator Joseph F. Vitale today introduced legislation that would require New Jersey hospitals to implement a facility-wide plan to prevent the spread of MRSA, an antibiotic-resistant staph infection that can be life-threatening in hospital settings but is preventable through the use of basic infection control procedures.
“MRSA is a serious infection that is resistant to most antibiotics, but aggressive prevention measures have proven successful in stemming the spread of this potentially fatal illness,” said Senator Buono (D-Middlesex). “Requiring prevention strategies be employed throughout hospitals in every facility in the state, with front-line hospital staff engaged in the process, will be a significant step forward in protecting patients against contracting this infection and ensuring our hospitals are safe.”
Current law requires that hospitals have prevention programs for MRSA (methicillin-resistant Staphylococcus aureus) in intensive care units, or if the facility does not have an ICU, in other high-risk areas of the hospital such as surgical units. As signed in 2007, the law called for hospitals to ultimately expand their successful prevention strategies throughout their facilities, but included no designated timeline for implementation. The senator’s bill would expand the law to require state-licensed hospitals to have a prevention program in place for the entire facility, excluding psychiatric care units, within 30 days of the law’s enactment.
“While patients within intensive care units are at high risk for contracting an antibiotic-resistant staph infection because of the nature of their medical conditions, the potential to have contact with MRSA is real in nearly every unit of a health care facility,” said Senator Vitale (D-Middlesex). “What’s more, this infection, which in its most serious form can be deadly, is both preventable and controllable through the use of basic hygienic practices.”
In the community, most MRSA infections are skin infections. However, more severe or potentially life-threatening MRSA infections occur most frequently among patients in healthcare settings, where the infection is typically spread from patient to patient on unclean hands of healthcare personnel or through the improper use of equipment, according to the Centers for Disease Control and Prevention. Basic infection control procedures are key to preventing the spread of MRSA, according to the CDC.
In addition to best practices, current law requires hospitals to:
• Implement a written infections prevention and control policy with input from frontline caregivers;
• Identify and isolate MRSA colonized (carried by a patient with no signs or symptoms) and MRSA infected patients by screening through a nasal swab test upon admission, in order to break the chain of transmission;
• Use contact precautions for patients found to be MRSA positive, which include placing infected patients in single room when possible and using gloves at all times when touching the patient’s intact skin or items in close proximity to the patient, including medical equipment and bed rails;
• Take patient cultures for MRSA upon discharge (currently from the ICU, or high risk unit) and flagging of patients who are readmitted;
• Strictly adhere to hygiene guidelines; and
• Adhere to a worker education requirement regarding modes of transmission, use of protective equipment, disinfection policies and procedures and other preventive measures.
Such basic strategies have proven extraordinarily successful in a number of hospitals across the country. A study conducted over a three-year period, from 2006-2008, involving six hospitals which adhered to rigorous prevention plans crafted with input from employees showed significantly reduced MRSA rates in those facilities. The hospitals – which included Albert Einstein Medical Center in Philadelphia, Johns Hopkins Hospital in Baltimore and the VA Pittsburgh Healthcare System – reduced their collective rate of MRSA infection by 65 to 70 percent, according to a published report.
“Prevention has proven particularly successful in hospitals that have involved their employees in creating prevention and control policies, because the entire staff views it as their duty to prevent the spread of infection,” said Senator Buono. “Promoting a serious effort statewide to put these strategies in place throughout every hospital in the state will safeguard our facilities and prevent the spread of MRSA, which ultimately will save lives.”