Compliance with methicillin-resistant Staphylococcus aureus precautions in a teaching hospital.
BACKGROUND
Nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) occurs primarily through the contaminated hands of health care workers who do not follow appropriate precautionary measures. This study investigates various factors associated with compliance with MRSA precautions during routine patient care.


METHODS
This observational study took place at a teaching hospital in Montreal, Canada. Nurses (184), physicians (41), occupational therapists and physical therapists (19), orderlies (102), housekeeping personnel (28), other health care workers (65), and visitors (49) were anonymously observed. Compliance with MRSA precautions was measured according to appropriate use of gowns and gloves as well as hand hygiene.


RESULTS
In 488 observations, the average compliance was 28%. In multivariate analysis, in comparison with nurses, compliance was lower among physicians (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.14 to 0.86), orderlies (OR, 0.37; CI, 0.2-0.69), visitors (OR, 0.2; CI, 0.08-0.49), housekeeping personnel (OR, 0.06; CI, 0.01-0.47), and other types of health care workers (OR, 0.39; CI, 0.18-0.85), but was higher among occupational and physical therapists (OR, 11.7; CI, 2.55-53.8).


CONCLUSIONS
Compliance with MRSA precautions is low. The only significant predictor of MRSA compliance was the professional category of the health care worker.
Afif
Waqqas
W
Infection Control Service, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada.
Huor
Panhavat
P
Brassard
Paul
P
Loo
Vivian G
VG
D002170:Canada; D005260:Female; D006235:Hand Disinfection / Q000592:standards; D007722:Health Knowledge, Attitudes, Practice; D006784:Hospitals, Teaching / Q000592:standards; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000592:standards*; D008297:Male; D008712:Methicillin / Q000494:pharmacology; D016106:Methicillin Resistance; D010564:Personnel, Hospital / Q000592:standards*; D013203:Staphylococcal Infections / Q000382:microbiology* / Q000517:prevention & control* / Q000635:transmission; D013211:Staphylococcus aureus / Q000187:drug effects
D008712:Methicillin