The Department of Veterans Affairs (VA) announced some excellent news concerning patient care recently. Although their failures have been highlighted in the news lately, they appear to be doing some good as well.
According to the American Journal of Infection Control, the rate of methicillin-resistant Staphylococcus aureus (MRSA) has dropped dramatically for the Veterans Health Administration over the past eight years. This information may seem overwhelming or unimportant, but it is actually great news.
MRSA is a Terrible Infection
When people talk about getting a staph infection, they usually mean MRSA. Staph is a shortened form of Staphylococcus aureus, a common bacterial species that can be found on human skin and everyday objects. The difference between common staph and a staph infection depends on the patient's immune system and the level of resistance that staph has to antibiotics.
MRSA has become a fairly common deadly infection of the modern age. With the development of antibiotics and vaccines, most deadly diseases have become extinct or at least manageable. The problem with MRSA is the fact that this bacterial species has developed defenses against most antibiotics, making it very difficult to kill.
The typical treatment for an MRSA infection is infusing a much stronger antibiotic called vancomycin. Unfortunately, this powerful antibiotic can be toxic to the patient and can trigger secondary health problems.
That is one of the reasons the VA has found it so important to decrease the rate of MRSA infection. One of the worst ways in which it is transmitted has been from healthcare workers or hospitals, which is called a healthcare associated infection (HAI) of MRSA.
Spread of MRSA in the Medical Setting
The two ways in which people acquire MRSA infections are in the community or in healthcare facilities. When the CDC mentions community acquired MRSA, they are referring to either infections from wounds that did not occur in the hospital, like an injury from an accident, or when MRSA is spread in the community from transmission between people. Some people can even be carriers of this bacteria and not know it.
The most dangerous way MRSA is spread comes from the people trying their best to keep others healthy. The spread of HAI MRSA tends to occur when healthcare workers do not properly disinfect items or wash their hands between patients. Sometimes healthcare workers just need better training to understand their role in the spread of HAI MRSA.
Veterans Health Administration Combats MRSA
As the rate of HAI MRSA rose over the past decade, the CDC has taken steps to educate healthcare workers and the public. The VA jumped on board and begin taking necessary steps to reduce rates in their healthcare facilities. In 2014, the Veterans Health Administration provided a press release updating the public on changes they made and how effective these changes were in combating MRSA.
Due to the serious nature of MRSA and the VA's role as a leader of healthcare reform, several initiatives were put in place for VA health facilities. These measures included patient screening, contact precautions for MRSA carriers, hand hygiene reminders, conveniently located hand sanitizer, healthcare worker training and feedback from medical staff.
How the VA Implemented Changes
Essentially, every patient is screened for MRSA before they are admitted to an inpatient ward of the hospital. If they are a carrier or have a history of MRSA, then they are put on contact precautions. This means everyone who enters the patient's room needs to put on a disposable gown and gloves. When they leave the room, the gown and gloves are thrown away and they are supposed to use hand sanitizer.
Bottles of hand sanitizer were placed in every doorway to make hand cleaning convenient. Also signs were posted throughout the medical facilities reminding people to wash or sanitize their hands.
The VA also began monitoring healthcare workers for proper hand hygiene, with remedial training for those who failed. Online hand hygiene training was implemented for all healthcare employees to ensure uniformity in proper technique and to educate employees on their role in preventing HAI among patients.
Significant Decline in MRSA HAI
By directing attention to the specific problem of MRSA HAI, the VA was able to successfully reduce the rates of infection. The VA began focusing their energy on this problem back in October of 2007 and provided a five year update in their October 2014 news release.
The report showing the progressive trend toward the goal of preventing MRSA HAI was very encouraging. The American Journal of Infection Control gathered the final statistics over an eight year time span for their recently published article on the subject. According to the authors of this article, monthly rates of HAI dropped by 87% for intensive care unit patients. Throughout the eight year study, there were significant declines in MRSA HAI for all VA healthcare units. This is great news for the nation's veterans and their families.
The VA as a Healthcare Leader
As the largest single healthcare system in the nation, the Veterans Health Administration has a massive responsibility for the people who protect and defend our freedom. They must also be the leaders in quality healthcare.
Often the news will shed light on their failures while pointing out how terribly the government manages healthcare. As one of the biggest challenges in healthcare, the reduction of HAI MRSA by such large margins is no small feat.
This initiative has proven to be a great example of how to improve patient care with plenty of data to back it up. Perhaps the future of medicine will include utilizing these techniques nationwide to provide a culture of excellent healthcare.
American Journal of Infection Control, January 2017. Eight years of decreased methicillin-resistant Staphylococcus aureus health care-associated infections associated with a Veterans Affairs prevention initiative. Website: http://www.ajicjournal.org/article/S0196-6553(16)30814-8/abstract
Centers for Disease Control and Prevention, 2016. Methicillin-resistant Staphylococcus aureus. Website: https://www.cdc.gov/mrsa/
Veterans Health Administration, 2014. VA Sharply Reduces Drug-Resistant Staph Infections in Hospitalized Veterans. Website: https://www.va.gov/opa/pressrel/pressrelease.cfm?id=2642