Improving the timeliness of meticillin-resistant Staphylococcus aureus antimicrobial decolonization therapy administration : a descriptive account

Background
It is important to ensure that the timely administration of appropriate antimicrobial decolonization therapy occurs when patients are identified as meticillin-resistant Staphylococcus aureus (MRSA)-colonized. Computerized Provider Order Entry (CPOE) with embedded Clinical Decision Support (CDS) may help to facilitate this.

Aim
To investigate changes in the average time from patient admission to administration of MRSA decolonization antimicrobial therapy in the context of various national and local infection control interventions, including the use of CPOE.

Methods
Data concerning the time of admission and of administration of patients' first MRSA decolonization antimicrobials were extracted from a locally developed CPOE system (Prescribing Investigation and Communications System: PICS) which was introduced at a large university teaching hospital in the UK in 1998. Data were extracted retrospectively from January 2006 to March 2012.

Findings
A variety of relevant local and national interventions occurred from 2006 to 2012. Notably, the automatic charting of MRSA decolonization antimicrobial therapy was introduced in December 2007. There was a significant decline of 15.0% per year (95% confidence interval: 11.1–18.7%; P < 0.001) in the time taken from admission to administration of MRSA decolonization antimicrobial therapy during the study period.

Conclusions
Numerous factors may have contributed to the observed reductions in the time from admission to administration of MRSA decolonization antimicrobials, including the implementation of specific features within a CPOE system. By rapidly attending to positive MRSA colonizations there is decreased potential for MRSA to spread, which may help to reduce the prevalence of MRSA colonizations within hospitals and improve patient outcomes.