Reduction of hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) bacteremia with the use of twice daily alcohol-based nasal antiseptic in intensive care units.

Background: A 191-bed hospital within a Midwest health care system experienced an increase in hospital acquired Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. In response, the hospital sought a targeted intervention for MRSA prevention within 2 intensive care units using an alcohol based nasal antiseptic.

Methods: In August 2021, Infection Prevention and Control (IPC) partnered with Nursing and the alcohol-based nasal antiseptic product vendor to implement the product in the 2 units. Nasal antiseptic was administered twice daily. To measure process adherence, a report was created within the electronic medical record to track compliance. Patient tracking and communication of data reports to nurse leadership by IPC began shortly afterward.

Results: MRSA standardized infection ratios (SIR) declined with an SIR of 1.18 in 2021 to an SIR of 0.90 in 2023. The total number of MRSA cases decreased from 2021 to 2022 with 4 cases and 1 case, respectively.

Discussion: Barriers were identified, including personnel permitted to administer alcohol-based antiseptic, product location, and administration documentation. As these were addressed, compliance in administration began to increase. Manually tracking compliance was later replaced with an automated report for sustainability purposes. Options available to analyze the data were limited due to lack of control data.

Conclusion: Implementation of universal decolonization using twice daily alcohol based nasal antiseptic can be accomplished and assessed with the development of an electronic data tracking process.