Impact of admission screening for methicillin-resistant Staphylococcus aureus on the length of stay in an emergency department.

Hdl Handle:
http://hdl.handle.net/10147/126574
Title:
Impact of admission screening for methicillin-resistant Staphylococcus aureus on the length of stay in an emergency department.
Authors:
Gilligan, P; Quirke, M; Winder, S; Humphreys, H
Affiliation:
Emergency Department, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland. hegartydeirdre@ireland.com
Citation:
Impact of admission screening for methicillin-resistant Staphylococcus aureus on the length of stay in an emergency department. 2010, 75 (2):99-102 J. Hosp. Infect.
Journal:
The Journal of hospital infection
Issue Date:
Jun-2010
URI:
http://hdl.handle.net/10147/126574
DOI:
10.1016/j.jhin.2010.01.019
PubMed ID:
20381911
Abstract:
Preventing and controlling methicillin-resistant Staphylococcus aureus (MRSA) includes early detection and isolation. In the emergency department (ED), such measures have to be balanced with the requirement to treat patients urgently and transfer quickly to an acute hospital bed. We assessed, in a busy and overcrowded ED, the contribution made to a patient's stay by previous MRSA risk group identification and by selective rescreening of those patients who were previously documented in the research hospital as being MRSA positive. Patients with a previous diagnosis of MRSA colonisation were flagged automatically as 'risk group' (RG) on their arrival in the ED and were compared with 'non-risk group' (NRG), i.e. not previously demonstrated in the research hospital to be infected or colonised with MRSA. Over an 18 month period, there were 16 456 admissions via the ED, of which 985 (6%) were RG patients. The expected median times to be admitted following a request for a ward bed for NRG and RG patients were 10.4 and 12.9h, respectively. Female sex, age >65 years, and RG status all independently predicted a statistically significantly longer stay in the ED following a request for a hospital bed. We consider that national and local policies for MRSA need to balance the welfare of patients in the ED with the need to comply with best practice, when there are inadequate ED and inpatient isolation facilities. Patients with MRSA requiring emergency admission must have a bed available for them.
Item Type:
Article
Language:
en
MeSH:
Aged; Aged, 80 and over; Carrier State; Diagnostic Tests, Routine; Emergency Service, Hospital; Female; Humans; Ireland; Length of Stay; Male; Mass Screening; Methicillin-Resistant Staphylococcus aureus; Staphylococcal Infections
ISSN:
1532-2939

Full metadata record

DC FieldValue Language
dc.contributor.authorGilligan, Pen
dc.contributor.authorQuirke, Men
dc.contributor.authorWinder, Sen
dc.contributor.authorHumphreys, Hen
dc.date.accessioned2011-03-31T13:13:09Z-
dc.date.available2011-03-31T13:13:09Z-
dc.date.issued2010-06-
dc.identifier.citationImpact of admission screening for methicillin-resistant Staphylococcus aureus on the length of stay in an emergency department. 2010, 75 (2):99-102 J. Hosp. Infect.en
dc.identifier.issn1532-2939-
dc.identifier.pmid20381911-
dc.identifier.doi10.1016/j.jhin.2010.01.019-
dc.identifier.urihttp://hdl.handle.net/10147/126574-
dc.description.abstractPreventing and controlling methicillin-resistant Staphylococcus aureus (MRSA) includes early detection and isolation. In the emergency department (ED), such measures have to be balanced with the requirement to treat patients urgently and transfer quickly to an acute hospital bed. We assessed, in a busy and overcrowded ED, the contribution made to a patient's stay by previous MRSA risk group identification and by selective rescreening of those patients who were previously documented in the research hospital as being MRSA positive. Patients with a previous diagnosis of MRSA colonisation were flagged automatically as 'risk group' (RG) on their arrival in the ED and were compared with 'non-risk group' (NRG), i.e. not previously demonstrated in the research hospital to be infected or colonised with MRSA. Over an 18 month period, there were 16 456 admissions via the ED, of which 985 (6%) were RG patients. The expected median times to be admitted following a request for a ward bed for NRG and RG patients were 10.4 and 12.9h, respectively. Female sex, age >65 years, and RG status all independently predicted a statistically significantly longer stay in the ED following a request for a hospital bed. We consider that national and local policies for MRSA need to balance the welfare of patients in the ED with the need to comply with best practice, when there are inadequate ED and inpatient isolation facilities. Patients with MRSA requiring emergency admission must have a bed available for them.-
dc.language.isoenen
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshCarrier State-
dc.subject.meshDiagnostic Tests, Routine-
dc.subject.meshEmergency Service, Hospital-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshIreland-
dc.subject.meshLength of Stay-
dc.subject.meshMale-
dc.subject.meshMass Screening-
dc.subject.meshMethicillin-Resistant Staphylococcus aureus-
dc.subject.meshStaphylococcal Infections-
dc.titleImpact of admission screening for methicillin-resistant Staphylococcus aureus on the length of stay in an emergency department.en
dc.typeArticleen
dc.contributor.departmentEmergency Department, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland. hegartydeirdre@ireland.comen
dc.identifier.journalThe Journal of hospital infectionen
dc.description.provinceLeinster-

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