Study finds wide variation in ICU infection-control methods

Despite the looming threat of multidrug-resistant organisms, authors of a new study found wide variations in hospitals' screening and infection-control practices within their intensive-care units.

Researchers from the Columbia University School of Nursing, New York, surveyed infection-control managers from 250 hospitals to compare the methods they use to detect and prevent infections in the ICU. They found that 59% of respondents routinely screened for methicillin-resistant Staphylococcus aureas, or MRSA, but far fewer regularly screened for Clostridium difficile—11%—or vancomycin-resistant Enterococcus—22%.

Twenty-seven percent of ICUs reported having a policy in place for periodic screening following admission, while 40% had a written policy for screening multidrug-resistant organisms, according to the study, which appeared in the October issue of the American Journal of Infection Control.

Hospitals' policies were affected by whether they were located in a state that mandated public reporting of infections, the authors found. They also noted that the Centers for Disease Control and Prevention, the Society for Healthcare Epidemiology of America and other organizations have different sets of recommendations.

“Rather than being driven by legislative mandates that are not evidence-based, (multidrug-resistant organism) screening should be based on a facility's risk assessment, as the epidemiology of these organisms can vary from region to region,” said Michelle Farber, president of the Association for Professionals in Infection Control and Epidemiology, in a news release. “APIC recommends that each institution design an HAI prevention program that is effective for their facility and needs.”