Preventing Transmission of Methicillin-Resistant Staphylococcus Aureus in the Hospital Setting: Perspectives From Health Care Workers

Background: As healthcare facilities look to the future, addressing the problem of colonization of methicillin-resistant staphylococcus aureus (MRSA) is essential in creating healthier environments for patients and health care workers. As the leading cause of nosocomial infections in hospitalized patients, MRSA is associated with increased morbidity and mortality.

Purpose: To evaluate original research exploring health care workers’ perspectives towards MRSA transmission prevention practices.

Methods: A PubMed, CINAHL, and Cochrane Review search was conducted using the keywords MRSA, methicillin-resistant staphylococcus aureus, health care workers, nurse, transmission, hospital, prevention. Criteria for inclusion were: articles that were peer reviewed, published in the last 10 years, that reported perspectives of health care workers. Although qualitative studies were targeted to reveal first hand experiences of health care workers, mixed methods and observational studies were included as well. Abstracts were reviewed for eligibility and article summaries were written.

Results: To date, preliminary results of this ongoing literature search indicate that some health care workers are more confident about their knowledge of MRSA transmission and prevention practices than others. Barriers to adherence of prevention practices were identified including lack of knowledge, time to implement known prevention measures, decreased staff to patient ratios, and being afraid or insecure with working with patients who were on MRSA precautions. In addition, studies that compared direct observations of prevention practices to self-reported adherence rates showed health care workers overestimated their adherence.

Implications: Knowledge of first-hand experiences of health care workers, including whether self-reported adherence aligns with observations by researchers, will provide information that can be used to develop education and skill building interventions to decrease transmission of MRSA by health care workers. These interventions need to include ways to increase comfort level of health care workers when working with patients who have MRSA, especially those with less training (such as ancillary nursing staff).