Cluster randomised controlled trial of an infection control education and training intervention programme focusing on meticillin-resistant Staphylococcus aureus in nursing homes for older people

Summary The aim of this cluster randomised controlled trial was to test the impact of an infection control education and training programme on meticillin-resistant Staphylococcus aureus (MRSA) prevalence in nursing homes. Nursing homes were randomised to intervention (infection control education and...

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Bibliographic Details
Published in:	The Journal of hospital infection Vol. 76; no. 1; pp. 36 - 41
Main Authors:	Baldwin, N.S, Gilpin, D.F, Tunney, M.M, Kearney, M.P, Crymble, L, Cardwell, C, Hughes, C.M
Format:	Journal Article
Language:	English
Published:	Kidlington Elsevier Ltd 01-09-2010 Elsevier
Subjects:	Aged Aged, 80 and over Bacterial diseases Biological and medical sciences Carrier State - epidemiology Carrier State - microbiology Carrier State - prevention & control Cluster randomised controlled trial Cross Infection - epidemiology Cross Infection - microbiology Cross Infection - prevention & control Education, Medical - methods Female Guideline Adherence - statistics & numerical data Human bacterial diseases Humans Infection control Infection Control - methods Infectious Disease Infectious diseases Male Medical sciences Methicillin-Resistant Staphylococcus aureus - isolation & purification Meticillin-resistant Staphylococcus aureus Nose - microbiology Nursing Homes Prevalence Staphylococcal Infections - epidemiology Staphylococcal Infections - microbiology Staphylococcal Infections - prevention & control Staphylococcal infections, streptococcal infections, pneumococcal infections Staphylococcus aureus United Kingdom > UK Northern Ireland Nursing homes Cluster randomised controlled trial Meticillin-resistant Staphylococcus aureus Infection control Check Infection Prevention Sanitary control Education Bacteriosis Bacteria Micrococcales Micrococcaceae Homes for the aged Staphylococcal infection Public health Staphylococcus aureus
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Summary:	Summary The aim of this cluster randomised controlled trial was to test the impact of an infection control education and training programme on meticillin-resistant Staphylococcus aureus (MRSA) prevalence in nursing homes. Nursing homes were randomised to intervention (infection control education and training programme; N = 16) or control (usual practice continued; N = 16). Staff in intervention homes were educated and trained (0, 3 and 6 months) in the principles and implementation of good infection control practice with infection control audits conducted in all sites (0, 3, 6 and 12 months) to assess compliance with good practice. Audit scores were fed back to nursing home managers in intervention homes, together with a written report indicating where practice could be improved. Nasal swabs were taken from all consenting residents and staff at 0, 3, 6 and 12 months. The primary outcome was MRSA prevalence in residents and staff, and the secondary outcome was a change in infection control audit scores. In all, 793 residents and 338 staff were recruited at baseline. MRSA prevalence did not change during the study in residents or staff. The relative risk of a resident being colonised with MRSA in an intervention home compared with a control home at 12 months was 0.99 (95% confidence interval: 0.69, 1.42) after adjustment for clustering. Mean infection control audit scores were significantly higher in the intervention homes (82%) compared with the control homes (64%) at 12 months ( P < 0.0001). Consideration should be given to other approaches which may help to reduce MRSA in this setting.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23 ObjectType-Feature-1
ISSN:	0195-6701 1532-2939
DOI:	10.1016/j.jhin.2010.03.006