title: Hospital staff perceptions of a legislative mandate for methicillin-resistant Staphylococcus aureus screening.
abstract: OBJECTIVE
  In August 2007, Illinois passed legislation mandating methicillin-resistant Staphylococcus aureus (MRSA) admission screening for intensive care unit patients. We assessed hospital staff perceptions of the implementation of this law.
  
  
  METHODS
  Mixed-methods evaluation using structured focus groups and questionnaires.
  
  
  METHODS
  Eight Chicago-area hospitals.
  
  
  METHODS
  Three strata of staff (leadership, midlevel, and frontline) at each hospital.
  
  
  METHODS
  All participants completed a questionnaire and participated in a focus group. Focus group transcripts were thematically coded and analyzed. The proportion of staff agreeing with statements about MRSA and the legislation was compared across staff types.
  
  
  RESULTS
  Overall, 126 hospital staff participated in 23 focus groups. Fifty-six percent of participants agreed that the legislation had a positive effect at their facility; frontline staff were more likely to agree than midlevel and leadership staff (P < .01). Perceived benefits of the legislation included increased awareness of MRSA among staff and better knowledge of the epidemiology of MRSA colonization. Perceived negative consequences included the psychosocial effect of screening and contact precautions on patients and increased use of resources. Most participants (59%) would choose to continue the activities associated with the legislation but advised facilities in states considering similar legislation to educate staff and patients about MRSA screening and to draft clear implementation plans.
  
  
  CONCLUSIONS
  Staff from Chicago-area hospitals perceived that mandatory MRSA screening legislation resulted in some benefits but highlighted implementation challenges. States considering similar initiatives might minimize these challenges by optimizing messaging to patients and healthcare staff, drafting implementation plans, and developing program evaluation strategies.
authors.affiliation: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. cxx4@cdc.gov
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Wise
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Weber
authors.forename: Amy
authors.initials: A
authors.lastname: Schneider
authors.forename: Meg
authors.initials: M
authors.lastname: Stojcevski
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: France
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Schaefer
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Lin
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Kallen
authors.forename: Ronda L
authors.initials: RL
authors.lastname: Cochran
mesh_terms: D001291:Attitude of Health Personnel; D002641:Chicago; D017144:Focus Groups; D006801:Humans; D018580:Mandatory Testing / Q000331:legislation & jurisprudence*; D008505:Medical Staff, Hospital / Q000523:psychology*; D055624:Methicillin-Resistant Staphylococcus aureus; D010343:Patient Admission / Q000331:legislation & jurisprudence*; D013203:Staphylococcal Infections / Q000517:prevention & control*; D011795:Surveys and Questionnaires