1. Fairview Hospital 29 Lewis Avenue Great Barrington, MA 01230
Geraldine A. McQuoid RN, MA, MSN
Director of Education and Infection Control
Protocols for MRSA management in a
25-bed Federally designated
Critical Access Hospital

2. Collaboration with our local Long Term Care Facilities
Higher susceptibility & communicability of infections
Impact on Hospital census
Industry trends in the diagnosis & treatment of MRSA
Rapid MRSA PCR test
bilateral swab of the anterior nares
24-hour turn around time
VIP Screen {EMR}
Point of admission, institute precautions
Bed availability
Private room
Over 67% of our patients come from three local long term care facilities. Patients in these facilities/institutional environments have higher susceptibility and communicability. This impacts Fairview as we make decisions on our specific hospital population in regards to MRSA vs the current industry trends. EXPLAIN SWABS

3. LTC Testing of Residents / FVH Admission
Communication to residents & families
153 patients tested by ICP for reliability
33 patients tested positive for a total rate of 22%
Treatment options in LTC
Do not treat
Decolonization with Mupirocin
Institute precautions
Cohorting of patients
FVH Emergency Room protocol
MRSA PCR Swab on all residents not in our database
Onsite Education to LTC facility staff
Environmental recommendations
Extensive hand hygiene
Increased personal protective equipment
Ongoing communication
The project required the support of the Administrators at the facilities. Two of the three agreed to move forward. Letters were sent to all residents and families. In nursing home A, 82 patients were tested. In nursing home B, 71 patients were tested for a total of 153 patients.

4. On the Rise Who will be tested?
Community Acquired and Hospital Acquired MRSA continue to rise
LTC positive patients were asymptomatic for infection
Colonization often precedes clinical infection with MRSA
Often times deadly to geriatric patients
Decisive Action
CMS recent regulations on reimbursement
Outside influences:
CDC – SHEA – NIH
Cost of Universal Testing of admissions vs loss of revenue for Hospital Acquired MRSA infection
Who will be tested?
It is a fact that community acquired (CA) MRSA as well as hospital acquired (HA) MRSA is on the rise. The long term care residents who tested positive were asymptomatic for infection. These residents were colonized with MRSA. Colonization with MRSA often precedes full blown clinical MRSA infection which can be deadly for geriatric patient. Colonized patients with MRSA provide a substantial reservoir for person-to-person spread in the hospital.