The guidance, from Chief Medical Officer Dr Michael McBride, requires Trusts to identify those groups most at risk of MRSA infection and implement a screening policy based on those assessments.
The Best Practice Guidance on Screening for MRSA Colonisation in hospitals will help standardise approaches for vulnerable patients, and Trusts will undertake a number of key actions.
These include: pre-operative MRSA screening for patients in orthopaedics, cardio-thoracic surgery, and neurosurgery; assessing the feasibility of designating relevant surgical wards, especially orthopaedic wards, as ‘MRSA-free’ zones; screening all patients admitted to critical care on admission and at weekly intervals if their stay is prolonged; and screening all patients on renal dialysis on admission to the programme and then at regular intervals, determined by local practice.
The Minister said: “Lowering the rates of MRSA infections is a priority and I have set a target of a 10% reduction in this Healthcare Associated Infection (HCAI) by March 2009.
“This screening will help identify carriers of MRSA so that they may be appropriately treated to prevent onward transmission to others.
“This is an important component of our work to reduce MRSA infection in hospitals.”
He added: “Prevention and detection must be our key focus. Patients must be, as far as possible, prevented from picking up such infections in the first place.
“If they do have infections, all possible measures must be taken to prevent others from becoming infected, and we must ensure patients are treated quickly and appropriately.
“I want the public to have confidence in the care provided by hospitals and healthcare staff.”
In February The Minister announced a £9million investment over the next three years and a comprehensive range of measures to tackle Healthcare Associated Infections (HCAIs), like MRSA.
These included: unannounced hygiene inspections; single rooms for new hospitals; challenging targets to reduce C diff and MRSA; a dress code for staff; and restrictions on hospital visiting.
The Minister said: “It is clear that we can never fully eradicate infections such as MRSA, however by following robust and stringent infection control measures it is possible to reduce the rates of infection.
“My department already has a number of policies in place to tackle HCAIs including the Changing the Culture action plan and the Ward Sister’s charter which aim to reduce infection.
“I vow to continue to do everything in my power to support health trusts in the fight against superbugs.”
The guidance also covers issues in relation to sample collection, testing methods, decolonisation and isolation of MRSA positive patients.
The Department will continue to keep the evidence supporting MRSA screening under review and will issue updated guidance when appropriate.
Notes to Editors:
- Screening is one method of reducing MRSA infections, along with other infection control practices, use of appropriate isolation and cohorting facilities, and decolonisation.
- MRSA screening is carried out for high risk patients such as admissions to Intensive Care, neonatal and renal units, as well as for planned orthopaedic surgery and vascular grafts.
- The normal habitat of MRSA is human skin, particularly in the nares (nose), axilla (armpit), and perineum (groin). Clinical infection with MRSA (including MRSA Bacteraemia) occurs either from the patients own resident MRSA (if he or she is an asymptomatic carrier) or by transmission from another person (patient, staff or visitor) who could be an asymptomatic carrier or have a clinical infection.
- As soon as a patient is identified as an MRSA carrier, a decolonisation regimen should be started. This comprises the use of an antibacterial shampoo and body wash daily, and the application of an antibacterial nasal cream three times a day for five days. This should be done irrespective of whether facilities are available to isolate the patient. The purpose of decolonisation is to reduce the risk of the patient developing an MRSA infection with their own MRSA during medical or surgical treatment; and transmitting MRSA to another patient.
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