EVIDENCE-BASED PRACTICE IN THE PREVENTION OF NOSOCOMIAL

INFECTIONS
MRSA: Avoiding Infection in Hospital Care

Monica Montero
Lewis-Clark State College
2015

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NOSOCOMIAL INFECTIONS

The basis for safe and successful provision of patient care has been established in the
critical thinking model called nursing process. Its six steps (ADPIE) guide the provision of
health care in a holistic, multidisciplinary, and individualized approach to fit the specific
circumstances of each client (Potter and Perry, 2012) The nursing process model goes hand in
hand with the Standards of Professional Nursing Practices developed by the American Nursing
Association (ANA) to ensure nationwide standards, guidelines, and principles (nursingworld.org,
2015). Using these tools, I chose to explore the role of the RN as a provider of care with focus on
the preventive strategies to reduce the incidence of infection transmission of MRSA in the health
care facilities. Using the six steps of the Evidence Based Practice tool, I was able to develop my
PICO question: Which preventive strategies used by hospital personnel had proven successful in
preventing the spread of MRSA infection?
According to the ANA standard of care number 1, assessment starts with the nurse
collecting pertinent subjective and objective health data to determine immediate conditions or
needs in order to prioritize care. Nurses use a variety of tool and assessment techniques to collect
information from the client, their family, and other health providers to ensure the information is
valid and accurate since it will guide the formulation of a diagnosis and plan of care. The data I
found during my research brought up that MRSA accounts for almost 50% of nosocomial
infections acquired while a patient stays in the hospital and the added cost to care for
hospitalized patients with MRSA infections is higher and doubles the length of stay. In addition,
the mortality rate of patients that acquire MRSA increases from 2.1% to 4.7%, making the
geriatric population the most vulnerable to acquire this infection (Upshaw-Owens and Bailey,
2012). With this information a nurse in the role of care provider can identify the problem to
develop a plan of action, but the nurse is not to act alone in defining strategies of care. The nurse

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is an essential component in the multidisciplinary approach of providing health care. This

approach ensures that expects from different fields get together to research and develop
pertinent evidence-base practice (EBP) information to provide the most accurate practices,
techniques, and tools the nurse may have at her/his reach to use in planning and implementing
care.
Continuing with the ANA standard of care number 4, planning and development of an
individualized plan of care with specific intervention and realistic, measurable goals is the
responsibility of the nurse as the provider of care. An effective planning reflects current nursing
practice and involves the multidisciplinary approach for the solution of the assessed problem. It
is the nurses responsibility to identify interventions to attain an expected outcome. In our
nursing classes we are constantly lectured about the fact that nurses are the last line of defense
for patient; it is in the nurses hands to adopt and implement the necessary measures of
prevention and infection control practices. The professional journals I researched were directed
to the education of the nursing community to inform nurses that the implementation of
preventive strategies was proven effective in reducing the incidence of transmission of MRSA in
the hospital setting and it stressed that further success lies in the hands of the nursing personnel
(Guerry, Hiott, et al. (2006).
Another important ANA standard of care is number 5, implementation of the
interventions identified in the plan of care are carried out by the nurse as a continuation of the
role as the provider of care. The nurse should implement the interventions established in the plan
of care in a safe, appropriate, and timely manner. Interventions are documented and carried out in
an ongoing basis to ensure the success of the established goals.

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According to the research findings, in the case of the effective techniques to prevent
transmission of MRSA, there are seven types of evidence-based strategic interventions accepted
by the CDC in 2006. These are: administrative support for hospital personnel, use of
antimicrobials, surveillance, encouragement of use standard and contact precautions, hand
hygiene, contact isolation, environmental measures, education, and decolonization (UpshawOwens and Bailey, 2012).
Nurses play an important role in the education of the public about these measures in order
to successfully diminish the incidence of nosocomial infection due to MRSA infection. It is
important to encourage the use of standard precautions with the people that visit the hospital so
they are also aware of how to keep their loved ones safe.
Conclusion
This article brought to my attention that the role of nurses is of extreme importance. So much so,
that it is possible for a nurse to impact mortality rates due to nosocomial infections related to
MRSA and, thus, reduce hospital care cost by keeping patients MRSA free. It also empowers
nurses and explains in detail how and why nurses and other hospital personnel can and should
adopt infection prevention measures themselves and promote its education to further benefit the
population in the hospital. In my nursing practice I plan to implement careful, professional
infection control techniques and standard precautions to insure optimal care for each patient. It
is also very important to take seriously that however simple it may seem, washing hands really
can save lives. I definitely will implement this in the education of my patients and their visiting
families.

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References

Guerry C; Hiott M; Morrow N; Ward K; Salgado CD (2006) Infection Control & Hospital
Epidemiology. University of Chicago Press Journals Division Mar; 27 (3): 233-238.
ISSN 0899-823X
Pearsons, A. (Writer). (2013, August 19). Nurs5220-OL Guide to nursing research: Evidence
based practice/informatics Retrieved from
http://otterbein.libguides.wcsu.edu/content.php?pid=99329
Potter, Patricia A. & Perry, Anne Griffin, et al (2012) Fundamentals of Nursing
Ch 15 Critical Thinking in Nursing Practice and Ch 16 Nursing Process.
Upshaw-Owens, Marcella; Bailey, Catherine A. (2012). Preventing Hospital-Associated
Infection: MRSA.

MEDSURG Nursing (MEDSURG NURS), Mar-Apr; 21 (2): 77-81.