title: Fighting MRSA Infections in Hospital Care: How Organizational Factors Matter.
abstract: To identify factors associated with methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections at the level of the hospital organization.
  
  
  
  Data from all 173 acute trusts in the English National Health Service (NHS).
  
  
  
  A longitudinal study based on trust-level panel data for the 5-year period from April 2004 to March 2009. Fixed effects negative binominal and system generalized method of moment models were used to examine the effect of (i) patient mix characteristics, (ii) resource endowments, and (iii) infection control practices on yearly MRSA counts.
  
  
  
  Archival and staff survey data from multiple sources, including Public Health England, the English Department of Health, and the Healthcare Commission, were merged to form a balanced panel dataset.
  
  
  
  MRSA infections decrease with increases in general cleaning (-3.52 MRSA incidents per 1 standard deviation increase; 95 percent confidence interval: -6.61 to -0.44), infection control training (-3.29; -5.22 to -1.36), hand hygiene (-2.72; -4.76 to -0.68), and error reporting climate (-2.06; -4.09 to -0.04).
  
  
  
  Intensified general cleaning, improved hand hygiene, additional infection control training, and a climate conducive to error reporting emerged as the factors most closely associated with trust-level reductions in MRSA infections over time.
authors.affiliation: Innovation, Strategy and Organization Group (ISO) and TIME Research Area, RWTH Aachen University School of Business and Economics, Aachen, Germany.
authors.forename: Torsten Oliver
authors.initials: TO
authors.lastname: Salge
authors.affiliation: Department of Organization and Human Resource Management, German Police University, Münster, Germany.
authors.forename: Antonio
authors.initials: A
authors.lastname: Vera
authors.affiliation: Innovation, Strategy and Organization Group (ISO) and TIME Research Area, RWTH Aachen University School of Business and Economics, Aachen, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Antons
authors.affiliation: Florida Blue Center forHealth Care Quality, University of Florida College of Nursing, Gainesville, FL.
authors.forename: Jeannie P
authors.initials: JP
authors.lastname: Cimiotti
mesh_terms: D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control; D024901:Drug Resistance, Multiple, Bacterial; D004739:England; D006235:Hand Disinfection / Q000592:standards*; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000592:standards*; D007318:Inservice Training / Q000379:methods / Q000458:organization & administration*; D008137:Longitudinal Studies; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D009313:National Health Programs / Q000458:organization & administration; D019984:Quality Indicators, Health Care; D040841:Resource Allocation / Q000458:organization & administration; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000517:prevention & control*
keywords: 
  MRSA
  ; Health care-associated infections; National Health Service; panel data