New AHRQ Protocol Helps Hospitals Reduce MRSA and Bloodstream Infections
A new protocol released by AHRQ provides instructions for implementing universal decolonization in hospital intensive care units (ICUs) that treat adult patients. “Universal ICU Decolonization Toolkit: An Enhanced Protocol” is based on materials successfully used in the REDUCE MRSA Trial, results of which were published in the May 29 issue of the New England Journal of Medicine. The trial found that universal decolonization is the most effective intervention when compared with routine care or targeted decolonization, reducing MRSA clinical cultures by 37 percent and all-cause bloodstream infections by 44 percent.
The protocol provides:
· Decision-making tools and a rationale to help hospital leaders understand the effectiveness of ICU decolonization with mupirocin and chlorhexidine gluconate and decide if this strategy represents the best course of action for their facility.
· Instructions on how to garner institutional support from key stakeholders to support the adoption of a universal ICU decolonization strategy within ICUs.
· Tools to assess adherence to the decolonization protocol and reinforce training.
The protocol also describes the role of unit-based physician and nursing champions who oversee decolonization intervention and provide training and materials for front-line staff. Select to access the protocol.
Universal ICU Decolonization: An Enhanced Protocol
The REDUCE MRSA Trial (Randomized Evaluation of Decolonization vs. Universal Clearance to Eliminate Methicillin-Resistant Staphylococcus aureus) found that universal decolonization was the most effective intervention to reduce MRSA infections. This enhanced protocol provides instructions for implementing universal decolonization in adult intensive care units.
Prepared for:
Agency for Healthcare Research and Quality
Rockville, MD
Centers for Disease Control and Prevention
Atlanta, GA
Contract No. HHSA290201000008i
Prepared by:
The REDUCE MRSA Trial Working Group
Harvard Pilgrim Health Care
University of California Irvine
Hospital Corporation of America
Universal ICU Decolonization Protocol Overview
Scientific Rationale
References
Appendixes
Appendix A. Flow Chart for Implementing Universal Decolonization
Appendix B. Decisionmaking and Readiness for Implementation
Appendix C. Universal Decolonization in Adult ICUs Overview Statement
Appendix D. Universal ICU Decolonization Nursing Protocol
Appendix E. Training and Educational Materials
Universal ICU Decolonization
Universal ICU Decolonization Protocol for CHG Bathing
Protocol Training
Appendix F. Chlorhexidine Bathing Skills Assessment
Appendix G. Safety and Adverse Events
Authors
University of California Irvine
Susan Huang, MD, MPH
Adrijana Gombosev, BS
Leah Terpstra, BA
Harvard Pilgrim Health Care
Richard Platt, MD, MS
Julie Lankiewicz, MPH, CCRC
Katie Haffenreffer, BS
Hospital Corporation of America (HCA)
Edward Septimus, MD
Jason Hickok, MBA, RN
Julia Moody, MS
Jonathan Perlin, MD, PhD
John Stronger Hospital of Cook County
Robert Weinstein, MD
Rush University
Mary Hayden, MD
Centers for Disease Control and Prevention
Jonathan Jernigan, MD, MPH
Preparation of this enhanced protocol was supported by the Agency for Healthcare Research and Quality (AHRQ) through contract HHSA290201000008i. The opinions presented herein are those of the authors and do not necessarily represent the position of the U.S. Department of Health and Human Services, AHRQ, or the Centers for Disease Control and Prevention (CDC).
This protocol is in the public domain and may be reproduced and distributed without permission. Citation as to source is appreciated.
Prepared for:
Agency for Healthcare Research and Quality
Rockville, MD
Centers for Disease Control and Prevention
Atlanta, GA
Contract No. HHSA290201000008i
Prepared by:
The REDUCE MRSA Trial Working Group
Harvard Pilgrim Health Care
University of California Irvine
Hospital Corporation of America
Contents
Introduction and WelcomeUniversal ICU Decolonization Protocol Overview
Scientific Rationale
References
Appendixes
Appendix A. Flow Chart for Implementing Universal Decolonization
Appendix B. Decisionmaking and Readiness for Implementation
Appendix C. Universal Decolonization in Adult ICUs Overview Statement
Appendix D. Universal ICU Decolonization Nursing Protocol
Appendix E. Training and Educational Materials
Universal ICU Decolonization
Universal ICU Decolonization Protocol for CHG Bathing
Protocol Training
Appendix F. Chlorhexidine Bathing Skills Assessment
Appendix G. Safety and Adverse Events
Authors
University of California Irvine
Susan Huang, MD, MPH
Adrijana Gombosev, BS
Leah Terpstra, BA
Harvard Pilgrim Health Care
Richard Platt, MD, MS
Julie Lankiewicz, MPH, CCRC
Katie Haffenreffer, BS
Hospital Corporation of America (HCA)
Edward Septimus, MD
Jason Hickok, MBA, RN
Julia Moody, MS
Jonathan Perlin, MD, PhD
John Stronger Hospital of Cook County
Robert Weinstein, MD
Rush University
Mary Hayden, MD
Centers for Disease Control and Prevention
Jonathan Jernigan, MD, MPH
Preparation of this enhanced protocol was supported by the Agency for Healthcare Research and Quality (AHRQ) through contract HHSA290201000008i. The opinions presented herein are those of the authors and do not necessarily represent the position of the U.S. Department of Health and Human Services, AHRQ, or the Centers for Disease Control and Prevention (CDC).
This protocol is in the public domain and may be reproduced and distributed without permission. Citation as to source is appreciated.
Current as of September 2013
Internet Citation: Universal ICU Decolonization: An Enhanced Protocol. September 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/hospital/universal_icu_decolonization/index.html
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