Commonalities Across Hospitals Guide MRSA Bundle Implementation

After implementing changes to reduce methicillin-resistant
Staphylococcus aureus (MRSA) in intensive care units, researchers from Indiana found
five common themes imperative to successful bundle implementation and may serve
as a descriptive and systemic model for future initiatives.

“Our research found that while implementation plans should be
locally derived, reducing and preventing the spread of infections in intensive
care units entails overcoming common barriers,” Catherine Amber Welsh,
PhD, of the Indiana University Center for Health Services and Outcomes
Research, said in a press release.

In 2006, Welsh and colleagues collaborated with five Indianapolis
hospitals to implement four evidence-based practices: active surveillance, hand
hygiene, patient isolation and the use of personal protective equipment to
reduce MRSA transmission and infection in six intensive care unuts.

Six months after implementation, 24 team members were interviewed for an
in-depth understanding of the functioning of the bundle approach, perceived
effectiveness, challenges and key lessons learned.

Overall, 42 themes were reported, of which five themes were most common
among all hospitals and provided successful solutions to commonly encountered

  • Engage frontline staff in decision-making and implementation.
  • Build the right multidisciplinary team.
  • Commit to data collection, management and feedback.
  • Acquire and maintain management support.
  • Value of process mapping.

“The tendency for any organization unit is to say, ‘We’re
different,’ implying that change efforts must be tailor-made for each
unique group or culture,” Welsh said in the release. “But our
research shows that while units are unique, there are commonalities that can
guide consideration and planning efforts to implement new practices. We hope
that this study will help hospitals realize that change implementation is both
a unique and universal activity.”

For more information:

  • Welsh CA, Flanagan MEE, Kirss C, Doebbeling BN. Implementing the
    MRSA bundle in ICUs: one city collaborative’s key lessons learned.
    Infect Control Hosp Epidemiol. 2011;32:918-921.

Disclosure: This research was funded
by the US Agency for Healthcare Research and Quality (contract
HHSA2902006000131, under Office of Management and Budget control no. 0935-0168,
expiration date Sept. 30, 2012).

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