MRSA Infections
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Combine all elements completed in previous weeks (Topics 1-4) into one cohesive evidence-based proposal and share the proposal with a leader in your organization. (Appropriate individuals include unit managers, department directors, clinical supervisors, charge nurses, and clinical educators.)
Obtain feedback from the leader you have selected and request verification using the Capstone Review Form. Submit the signed Capstone Review Form to CONHCPfield@gcu.edu
For information on how to complete the assignment, refer to “Writing Guidelines” and the “Exemplar of Evidence-Based Practice Capstone Paper.”
Include a title page, abstract, problem statement, conclusion, reference section, and appendices (if tables, graphs, surveys, diagrams, etc. are created from tools required in Topic 4).
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7 NRS 441v.10R. Writing guidelines.docx 8 NRS 441v.10R.Exemplar of Evidenced-Based Practice.docx NRS441V.R.CapstoneReviewForm_1-27-14.docx
SAMPLE ANSWER
Abstract
The frequency of people with MRSA infections has increased considerably in recent years. In 2006, over 50% of all cases of skin infections because of MRSA happened in healthy persons living in the community. The 3 types of MRSA include healthcare-associated MRSA, hospital-associated MRSA, and community-associated MRSA. In the year 2008, MRSA resulted in about 89,786 cases of invasive disease leading to nearly 15,300 deaths in America. In the year 2008, roughly 27 percent of hospital-acquired MRSA infections were because of USA300 strains. MRSA is a major threat to communities and to patients in healthcare facilities. An MRSA infection can actually be more severe compared to other bacterial infections and can be life threatening. In America, studies indicate that MRSA is actually responsible for about 60 percent of community acquired infections with S Aureus presenting to healthcare facilities. The rates of MRSA is increasing rapidly in many regions and there is a dynamic spread of strains all over the world. At present, healthcare associated/acquired MRSA (HA-MRSA) is endemic in hospitals. The proposed solution for the prevention of MRSA is to provide education to individuals and communities on the ways to prevent the spread as well as transmission of the difficult-to-treat MRSA. The main reason for providing education to communities and individuals is essentially to promote health and prevent disease.
Problem Statement
MRSA is defined as an oxacillin minimal inhibitory concentration of at least 4 µg/mL (Raygada & Levine, 2010). The rates of MRSA keep on increasing in many countries around the world. Romano, Lu and Holtom (2011) stated that MRSA infections occur in 3 particular groupings of people: (i) those with recent hospitalization or continuing contact with dialysis units, medical clinics, or those who are going through intricate outpatient treatments, for instance chemotherapy. They are exposed to healthcare-associated MRSA. (ii) Those who are presently within the hospital setting, and these are exposed to hospital-associated MRSA. (iii) Those in the community and these are exposed to community-associated MRSA (Green et al., 2012). A person can become colonized, meaning to be infected with MRSA, by touching a surface which is contaminated, for instance a phone, a door handle, or a counter top; and by touching the skin of an individual colonized with MRSA (Raygada & Levine, 2009).
Mascitti et al. (2010) stated that Staphylococcus is a significant public health issue, and is known to be associated with infections that are difficult to treat. It is also linked to high incidences of mortality and morbidity, as well as increased costs of health care. Staphylococcus is essentially a bacterium which is carried on the nasal lining or skin of about 30% of healthy people (Stefani et al., 2012). In such settings, the bacteria usually does not cause any symptoms, and in such instances the individual is colonized with MRSA. Nonetheless, when the skin of that person is damaged, for instance is cut or scratched, this bacterium can bring about various problems ranging from severe illness to a mild pimple, particularly in elderly persons, children, and persons whose immune system is weakened (Koydemir et al., 2011). Methicillin-resistant staphylococcus aureus is a serious threat to the community and to patients in healthcare facilities. It is particularly difficult and expensive to treat because of its resistance to common antibiotics.
In the year 2006 in America, there were roughly 94,350 invasive MRSA infections, resulting in over 17,900 deaths annually (Green et al., 2012). In America, the proportion of hospital-acquired MRSA infections is high. From 2009 to 2010, 58.7 percent of S.aureus catheter-associated urinary tract infections, 54.6 percent of S. aureus central line associated bloodstream infections, 43.7 percent of S. aureus surgical site infections, and 48.4 percent of S. aureus ventilator-associated pneumonia episodes were caused by MRSA (Calfee et al., 2014). In the year 2008, MRSA resulted in about 89,786 cases of invasive disease leading to nearly 15,300 deaths in America (Prosperi et al., 2013). In the year 2008, roughly 27 percent of hospital-acquired MRSA infections were because of USA300 strains.
Community-associated MRSA was initially seen as a cause of infection in community-based people without any health care contact. The emergence of Community Acquired-MRSA as a cause of hospital acquired infections places many patients, health workers, as well as their community contacts possibly at risk of getting an MRSA infection (Otter & French, 2011). The emergence of community-associated MRSA also serves to expose its strains to the selective pressure of antibiotic usage in hospitals possibly leading to increased anti-biotic resistance. Different strains of CA-MRSA have invaded healthcare settings. In the year 2008, roughly 27 percent of hospital-acquired MRSA infections were because of USA300 strains. Currently, MRSA strains are resistant to the available β-lactam antibiotics, such as cephalosporins and penicillins. Gray (2014) pointed out that Methicillin-Resistant Staphylococcus Aureus are commonly not just resistant to methicillin and other β-lactam antibiotics, but they are also resistant to other classes of antibiotics.
MRSA is a major threat to communities and to patients in healthcare facilities. An MRSA infection can actually be more severe compared to other bacterial infections and can be life threatening. There is a growing occurrence of health care associated infections with MRSA in youngsters with underlying conditions predisposing to infection with S aureus. In America, studies indicate that MRSA is actually responsible for about 60 percent of community acquired infections with S. Aureus presenting to healthcare facilities (Gray, 2014). According to Stefani et al. (2012), the rates of MRSA is increasing rapidly in many regions and there is a dynamic spread of strains all over the world. At present, healthcare associated/acquired MRSA (HA-MRSA) is endemic in hospitals. The proposed solution for the prevention of MRSA is to provide education to individuals and communities on the ways to prevent the spread as well as transmission of the difficult-to-treat MRSA. The main reason for providing education to communities and individuals is essentially to promote health and prevent disease. The education activities would be targeted at healthcare workers and the community members in order to prevent community-associated MRSA, healthcare-associated MRSA, and hospital-associated MRSA. One of the most important ways of protecting community members, healthcare workers, and patients is by providing education both to patients and community members.
Conclusion
Methicillin-resistant staphylococcus aureus is a serious threat to the community and to patients in healthcare facilities. It is particularly difficult and expensive to treat because of its resistance to common antibiotics. In the year 2006 in America, there were roughly 94,350 invasive MRSA infections, resulting in over 17,900 deaths annually. There is a worldwide epidemic of CA-MRSA and different strains of CA-MRSA are emerging as a cause of healthcare-associated infections and hospital outbreaks have taken place all over the world. As an emerging cause of hospital-acquired infections, CA-MRSA puts many healthcare workers and patients potentially at risk of developing MRSA infection.
References
Calfee, D. P., Salgado, C.D., Milestone, A.M., Harris, A.D., Kuhar, D.T., Moody, J…Yokoe, D.S. (2014). Strategies to prevent Methicillin-resistant staphylococcus aureus transmission and infection in acute care hospitals: 2014 Update. Infection Control and Hospital Epidemiology, 35(7), 52-9. Retrieved from http://www.jstor.org/stable/10.1086/676534
Gray, J. W. (2014). MRSA: The problem reaches pediatrics. Archives of Disease in Childhood; 89: 297-298. Retrieved from http://adc.bmj.com/content/89/4/297.full
Green, B. N., Johnson, C. D., Egan, J. T., Rosenthal, M., Griffith, E. A., & Evans, M. W. (2012). Methicillin-resistant Staphylococcus aureus: An Overview for Manual Therapists. Journal of Chiropractic Medicine, 11(1), 64-76. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3315869/
Koydemir, C., Kulah, H., Ozgen, C., & Hascelik, G. (2011). Methicillin-resistant staphylococcus aureus biosensors for detection of Methicillin-resistant staphylococcus aureus. Biosensors and Bioelectronics, 29(1), 1-12. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21856144
Mascitti, K. B., Gerber, J. S., Zaoutis, T., Baron, T. D., & Lautenbach, E. (2010). Preferred treatment and prevention strategies for recurrent community-associated Methicillin-resistant staphylococcus aureus skin and soft-tissue infections: a survey of adult and pediatric providers. American Journal of Infection Control, 38(4), 324-328. Retrieved from http://www.ajicjournal.org/article/S0196-6553%2810%2900063-5/abstract
Otter, J. A., & French, G. L. (2011). Community-associated Methicillin-resistant staphylococcus aureus strains as a cause of healthcare-associate infection. Journal of Hospital Infection, 79(3), 189-193. Retrieved from http://www.journalofhospitalinfection.com/article/S0195-6701%2811%2900227-1/abstract
Prosperi, M., Veras, N., Azarian, T., Rathore, M., Nolan, D., Rand, K., Cook, R. L., Johnson, J., Morris, G. L., & Salemi, M. (2013). Molecular epidemiology of community-Associated Methicillin-resistant staphylococcus aureus in genomic era: A cross-sectional study. Science Reports, 3(1902), 1-7. Retrieved from www.ncbi.nlm.nih.gov/pmc/articles/PMC3664956/
Raygada, J. L., & Levine, D. P. (2009). Managing community associated- Methicillin resistant staphylococcus aureus infections: current and emerging options. Infections in Medicine, 12(4), 31-9. Retrieved from http://www.rheumatologynetwork.com/articles/managing-ca-mrsa-infections-current-and-emerging-options
Romano, R., Lu, D., & Holtom, P. (2010). Outbreak of community-acquired Methicillin -resistant staphylococcus aureus skin infections among a collegiate football team. Journal of Athletic Training, 41(2), 141-145.
Stefani, S., Chung, D. R., Lindsay, J. A., Friedrich, A. W., Kearns, A. M., Westh, H., & Mackenzie, F. M. (2012). Methicillin-resistant staphylococcus aureus (MRSA): global epidemiology and harmonization of typing methods. International Journal of Antimicrobial Agents, 39(4), 273-82. Retrieved from http://www.researchgate.net/publication/221733946_Meticillin-resistant_Staphylococcus_aureus_%28MRSA%29_global_epidemiology_and_harmonisation_of_typing_methods
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