title: Compliance of hospital staff with guidelines for the active surveillance of methicillin-resistant Staphylococcus aureus (MRSA) and its impact on rates of nosocomial MRSA bacteremia.
abstract: BACKGROUND
  The compliance of hospital staff with guidelines for the active surveillance of methicillin-resistant Staphylococcus aureus (MRSA) in Israel has not been determined.
  
  
  OBJECTIVE
  To evaluate the compliance of hospital staff with guidelines for the active surveillance of MRSA and assess its impact on the incidence of nosocomial MRSA bacteremia.
  
  
  METHODS
  We assessed compliance with MRSA surveillance guidelines by assessing adherence to the screening protocol and reviewing medical and nursing charts of patients colonized with MRSA, and observed hand hygiene opportunities among health care workers and colonized patients. Rates of nosocomial MRSA bacteremia and of adherence with hand hygiene among overall hospital staff were obtained from archived data for the period 2001-2010.
  
  
  RESULTS
  Only 32.4% of eligible patients were screened for MRSA carriage on admission, and 69.9% of MRSA carriers did not receive any eradication treatment. The mean rate of adherence to glove use among nurses and doctors was 69% and 31% respectively (P<0.01) and to hand hygiene 59% and 41% respectively (P<0.01). The hospital overall rate of adherence to hand hygiene increased from 42.3% in 2005 to 68.1% in 2010. Rates of nosocomial MRSA bacteremia decreased by 79.2%, from 0.48 (in 2001) to 0.1 (in 2010) per 1000 admissions (P<0.001).
  
  
  CONCLUSIONS
  The compliance of medical and nursing staff with guidelines for active MRSA surveillance was poor. The encouraging increase in adherence to hand hygiene and concomitant decrease in nosocomial MRSA bacteremia is gratifying. The deficiencies in compliance with MRSA infection control policy warrant an adjusted strategy based on the hospital resources.
authors.affiliation: Department of Medicine, Nazareth Hospital EMMS, Nazareth, Israel.
authors.forename: Marwan
authors.initials: M
authors.lastname: Zoabi
authors.forename: Yoram
authors.initials: Y
authors.lastname: Keness
authors.forename: Nava
authors.initials: N
authors.lastname: Titler
authors.forename: Naiel
authors.initials: N
authors.lastname: Bisharat
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002353:Carrier State / Q000382:microbiology; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D005260:Female; D019983:Guideline Adherence / Q000592:standards*; D006235:Hand Disinfection / Q000592:standards; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000592:standards; D007557:Israel; D008297:Male; D016106:Methicillin Resistance; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification / Q000472:pathogenicity; D009730:Nursing Assessment / Q000592:standards; D010564:Personnel, Hospital / Q000592:standards*; D011050:Policy Making; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission