Instructions for the Massachusetts MRSA Point Prevalence Survey (August 2008)
I. Overview of MRSA Point Prevalence Survey Recommendation
Hospitals will obtain MRSA nasal cultures on all ICU patients including patients known to be MRSA positive on the chosen day of the survey. The recommended technique for obtaining MRSA nasal swabs is to culture both anterior nares using a single sterile standard swab 1. The swab should be rotated in each nares two to five times clockwise and counterclockwise. The process should gently rub across the mucous membranes about three-fourths of an inch into the nasal passage (adults) so that squamous epithelial cells from inside the nose are obtained. Hospitals should follow specific hospital procedures for obtaining MRSA nasal swabs for infants and pediatric patients. Isolation of MRSA should be on routine agar, mannitol salt agar or comparable media, such as CHROMagar or PCR.
Surveillance of ICU(s) 2 must be completed within a single day during the 3 rd week in September (September 15-19).
Facilities with existing weekly MRSA active surveillance policies in which MRSA surveillance cultures are done on different days can choose to do the Massachusetts point prevalence surveys on the days their routine screenings are done during the designated week.
Individual patient data will be collected on all ICU patients who have a positive MRSA clinical culture or a positive MRSA surveillance culture during their current hospital admission. The patient's current hospital admission includes the patient's ICU admission and any other admission to a floor in the facility during the patient's current hospital stay.
II. Data Collection
The attached data collection form is divided into three parts:
Part I: Facility-wide data (completed once/hospital)
Part II: Results of MRSA nasal cultures obtained on ICU patients (completed once/hospital)
Part III: Individual patient data collected for each ICU patient who during their current hospital admission had a positive MRSA culture or PCR result from either 1) clinical culture or 2) MDPH point prevalence surveillance culture or 3) other routine active surveillance culture performed by the facility. (Completed once/each patient with a positive MRSA culture result). Additional copies of Part III may need to be made.
III. Submission of Data Forms
Hard copies of data forms must be submitted to The Betsy Lehman Center by October 10 th . Please send all hard copies to:
Betsy Lehman Center for Patient Safety & Medical Error Reduction
Attn: Eileen McHale
250 Washington Street
Boston, MA 02108
Via fax: 617-624-5046 Attn: Eileen McHale
Note: Facilities should make copies of all data forms submitted and retain the copies in a secure file for future reference. Please contact firstname.lastname@example.org if you have any questions.
1 APIC Guide- Elimination of Methicilin-Resistant Staph Aureus (MRSA) Transmission in Hospital Setting, March 2007
2 ICU definitions: ICUs (adult and pediatric) are defined as all intensive care units including but not limited to: medical ICUs, surgical ICUs, combined medical/surgical ICUs, neonatal ICUs, pediatric ICUs, coronary care units, neurologic ICUs, neurosurgery ICUs, cardiac ICUs, trauma ICUs, and burn ICUs.