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MRSA State Accountablity

Twenty-three states require hospitals to publicly report on health care-associated infections, including three that collect data on methicillin-resistant staph infections, according to a report released today by the Government Accountability Office.

Most of the states focus on a few measures developed or endorsed by the Centers for Disease Control and Prevention, and use the CDC's National Healthcare Safety Network to collect data.

In comments to GAO included in the report, AHA expressed concern that the HAI data collected through NHSN does not provide a valid comparative assessment of hospital performance, noting that the data submitted are not validated and hospitals vary in how they collect it. In addition to states, GAO reviewed 14 diverse hospitals and health systems with MRSA reduction initiatives.

All of them routinely tested for MRSA, but used varying testing methods, tested different patient populations, and needed varying levels of funding and staff to implement their initiatives.

Seven States Publish Report Cards

Lawmakers in seven states and the District of Columbia are debating bills that would require hospitals to take more aggressive steps to curb MRSA, including screening certain patients upon admission to determine whether they are colonized with MRSA. MRSA screening bills have been introduced in California, Hawaii, Iowa, Kentucky, Maryland, Missouri, Tennessee, and the District of Columbia. New Jersey lawmakers are considering legislation to expand the state's law to require hospitals to screen all incoming patients for MRSA. For more information, see: http://www.consumersunion.org/campaigns/2008%20state%20legislative%20web%20cha rt.pdf (Due to length of URL, please cut and paste into browser.)

At least seven other states already published report cards, including Colorado, Florida, New Jersey, New York, Pennsylvania, Texas, and Wisconsin. The U.S. Department of Health and Human Services currently publishes information regarding heart failure, pneumonia and surgical care, but there is no national database regarding the prevalence of health care-associated infections.

Three States Require MRSA Screening

Three states have passed laws requiring hospitals to screen certain patients for MRSA upon admission and similar proposals have been introduced in Congress and in seven states and the District of Columbia.

Illinois, New Jersey, and Pennsylvania -- have passed laws requiring hospitals to screen certain patients upon admission for MRSA. All three states require hospitals to screen patients admitted to Intensive Care Units and high risk patients in other parts of the hospital to identify those colonized with MRSA. For more information, see: http://www.consumersunion.org/campaigns/CU%20summary%20of%20MRSA%20laws%20as%2 0of%201-08.pdf (Due to length of URL, please cut and paste into browser.)

Consumers Union - Stop Hospital Infections

"We know that MRSA infections are all too common in hospitals across the country, but most hospitals are not doing enough to protect patients," said Lisa McGiffert, Director of Consumers Union's Stop Hospital Infections campaign ( www.StopHospitalInfections.org ). "Screening patients for MRSA is a critical part of an effective strategy to stem the alarming spread of these debilitating and sometimes deadly infections."

Consumers Union, publisher of Consumer Reports, is an independent, nonprofit testing and information organization serving only the consumer.  Established in 1936, their mission has been to test products, inform the public, and protect consumers. www.StopHospitalInfections.org , a project of Consumers Union, advocates for public disclosure of hospital-acquired infection rates.

Consumers Union supports efforts by states to require MRSA screening coupled with special precautions for those found colonized with the bacteria to prevent the spread of infections. For more information, see: http://www.consumersunion.org/pub/MRSA%20Policy%20Brief.pdf

A study by the Pennsylvania Health Care Cost Containment Council found that hospital patients with MRSA infections are four times as likely to die, will stay in the hospital two and a half times as long, and are charged three times as much compared to patients without MRSA infections.

A 2007 survey by the Association of Professionals in Infection Control (APIC) found that only 29 percent reported screening patients to identify those colonized with MRSA. Fifty percent of infection control professionals in a subsequent APIC survey said their hospital was not doing "as much as it could or should to stop the transmission of MRSA."

Federal Legislation

MRSA screening legislation also has been introduced in Congress. S. 2525, introduced by Senator Robert Menendez (D-NJ) initially would require hospitals to screen high risk patients for MRSA. Under the legislation, MRSA screening would be expanded to all patients admitted to hospitals by 2012. For more information on S. 2525 and other congressional bills, see: http://www.consumersunion.org/campaigns/Congressional%20Legislation%20110th%20 1-08.pdf (Due to length of URL, please cut and paste into browser.)

"Many antibiotics are ineffective for treating severe MRSA infections, so it is imperative that aggressive prevention strategies are implemented throughout the country," said McGiffert. "Stopping these infections from occurring in the first place is our best defense."

California Takes Broad Action Regarding HAIs

In September 2008 legislation in California created a robust prevention and surveillance system over deadly hospital infections-fostering improvements within hospitals and providing consumers with important information about hospital infection rates.

SB 1058 by Senator Elaine Alquist (D-San Jose) establishes the Medical Facility Infection Control and Prevention Act or "Nile's Law," which requires hospitals to develop more comprehensive policies and procedures to improve and ensure effective infection control practices. It also requires the Department of Public Health to establish a health care acquired infection program that will receive reports from hospitals on specified hospital-acquired infection rates. In addition, hospitals would be required to screen certain high-risk patients for Methicillin-Resistant Staphylococcus Aureus (MRSA) and to provide instructions regarding aftercare and precautions to prevent the spread of the infection to others.

SB 158 by Senator Dean Florez (D-Shafter) expands upon the current responsibilities of the existing California Department of Public Health's (CDPH) Healthcare Associated Infections Advisory Committee. The bill requires hospitals and skilled nursing facilities to establish plans to improve patient safety. This bill also contains detailed training requirements for hospital infection control committee chairs, clinicians, and all licensed and non-licensed hospital staff.

SB 891 by Senator Lou Correa (D-Santa Ana) builds on existing law that authorizes health facilities to practice Percutaneous coronary intervention (PCI) by establishing the Elective Percutaneous Coronary Intervention Pilot Program at CDPH. The program will authorize up to six eligible acute care hospitals that are licensed to provide cardiac catheterization laboratory service in California, and that meet prescribed, additional criteria to perform scheduled, elective primary percutaneous coronary intervention for eligible patients.