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Nursing Management:
doi: 10.1097/01.NUMA.0000431236.50026.23
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Targeting MRSA: Is it the right infection prevention goal?

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Targeting MRSA: Is it the right infection prevention goal?

GENERAL PURPOSE: To provide information about the variety of approaches to managing HAIs related to MRSA. LEARNING OBJECTIVES: After reading the article and taking this test, you'll be able to: 1. Describe the history of MRSA infection. 2. Discuss approaches to controlling HAIs related to MRSA.

1. In the 1950s and 1960s,

a. MRSA was identified as a community-acquired pathogen.

b. S. aureus was established as a healthcare-associated pathogen in North America.

c. MRSA infections rose to epidemic proportions.

d. S. aureus was identified as a healthcare-associated pathogen worldwide.

2. MRSA was first identified in

a. 1955.

b. 1959.

c. 1961.

d. 1965.

3. Methicillin was approved for treatment of aureus in

a. 1955.

b. 1959.

c. 1961.

d. 1965.

4. The MRSA epidemic of the late 1990s and early 2000s was characterized by

a. sicker inpatients becoming infected.

b. an increase in healthcare transmission.

c. transmission by healthcare employees.

d. the appearance of community-associated MRSA.

5. The USA300 strain of MRSA

a. developed independently in the community.

b. escaped from hospitals into the community.

c. was started by patients infected in the hospital.

d. was primarily associated with transmission by healthcare workers.

6. Contact precautions for MRSA

a. were accepted by a broad consensus as necessary to control the spread of infection.

b. don't seem to prevent the spread of the organism.

c. were heatedly contested.

d. have been shown to prevent the spread of HAIs into the community.

7. Regarding contact precautions for MRSA, the CDC guidelines

a. support their use.

b. question their use.

c. recommend more research on their efficacy.

d. deny their value.

8. One problem associated with the use of contact precautions is that

a. families object to the procedures required to visit their loved ones.

b. physicians refuse to change their PPE between patient visits.

c. healthcare professionals, including physicians, are half as likely to enter the patient's room.

d. families report increased anxiety and depression when their loved ones are in isolation.

9. Studies have demonstrated additional problems with contact isolation, including

a. restrictive visiting hours.

b. the inability to document care effectively.

c. reuse of PPE to save money.

d. higher patient acquisition rates of other MDROs.

10. To reduce the cost of PPE, some institutions

a. only require gowns for the sickest patients.

b. only require gowns when patient contact is anticipated.

c. leave a gown in a patient's room for reuse.

d. strictly limit the number of visits to each patient per day.

11. AST is the screening of

a. patients for MRSA on admission.

b. patients suspected to be infected or colonized with MRSA.

c. individuals in the community who are suspected to be infected with MRSA.

d. families of patients who are infected or colonized with MRSA.

12. In 2003, which organization issued guidelines recommending AST for MRSA?

a. CDC

b. Centers for Medicare and Medicaid Services

c. SHEA

d. Association for Professionals in Infection Control and Epidemiology

13. In a 2008 SHEA article, the authors noted that focusing on MRSA

a. increased the effectiveness of infection prevention protocols.

b. enhanced the researchers' abilities to develop targeted approaches to prevention and treatment.

c. brought national attention to the severity and threat of MRSA.

d. prevented fewer infections than broader approaches to infection prevention.

14. Recent data demonstrate that

a. MRSA is the most common healthcare-associated pathogen.

b. MRSA infections are declining.

c. practicing hand hygiene effectively eliminates MRSA.

d. community-associated MRSA is more prevalent now than hospital-acquired MRSA.

15. Which arm of the REDUCE MRSA Trial demonstrated the greatest reduction in ICU-attributed CLABSIs?

a. AST followed by contact precautions for MRSA-positive patients.

b. AST followed by mupirocin and CHG baths for MRSA-positive patients.

c. No AST; every patient was decolonized and bathed daily with CHG.

d. No AST; every patient was decolonized and their hand hygiene practices were monitored.

16. Best practice for infection prevention should include

a. a push toward targeting the most prevalent infectious agents.

b. a universal infection control approach that targets all HAIs.

c. emphasizing hand hygiene above all other infection prevention measures.

d. eliminating MRSA, the most hazardous of all current HAIs.

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