Examine the literature that exists to determine if it gives health care professionals (specifically nurses and doctors in acute hospitals) enough information to make the right choices about diagnosis and treatment of H-MRSA and C-MRSA.

By

TABLE OF CONTENTS

CHAPTER 1: INTRODUCTION1

Background and significance1

Theoretical framework1

Statement of the Problem2

Purpose of the study3

Aims and objectives3

Research questions4

CHAPTER 2: LITERATURE REVIEW5

Hospital prevalence of MRSA7

Community Prevalence of MRSA9

Role of Healthcare Workers10

Prevention and cure15

CHAPTER: METHODOLOGY20

Selecting research method20

Search strategy20

Electronic databases21

Authors searching21

Reference list checking22

Ethical Considerations22

Bias considered23

Critical appraisal tool used and why23

Data analysis24

REFERENCES25

CHAPTER 1: INTRODUCTION

Background and significance

Although the discovery of antibiotics "was heralded as a medical miracle," antimicrobial resistance quickly developed. At the same time penicillin was discovered in the 1930's and 1940's, the first isolate of penicillin-resistant aureus was also discovered, and with widespread use of penicillin in hospitals, resistance rapidly spread to pandemic proportions, and the antibiotic was rendered virtually useless. The pandemic of antibiotic resistance in hospitals led to the creation of the first hospital infection control programs (Gould 2009, p.1-8).

With the introduction of new antimicrobials, antimicrobial resistance continues to increase and antimicrobial resistance can be identified sometimes within months of the introduction of a new antimicrobial agent. With the growing number of antibiotics and the increasing use of antibiotics, and often misuse, MRSA incidence has grown exponentially, affecting millions of people and costing billions of dollars. The average cost of a hospital stay for MRSA infection is $14,000 compared to $7,600 for other types of hospital stays, and the length of hospitalization for MRSA infection is nearly double that of other types of stays, 10 days compared with 4.6 days respectively (Glaser 2007, p.47).

Theoretical framework

Healthcare workers are a high risk population for MRSA (Goetz et al., 1999), however they are often overlooked as a high-risk patient population for MRSA. Because they are healthcare workers, assumptions are made that they have knowledge of MRSA and that they are aware of the significance of their activities on the transmission of the pathogen (Gill 2006, p.333- 337).

However, a knowledge deficit may exist, and without understanding the rationale behind why healthcare workers are often noncompliant with infection control 3 practices, effective educational strategies cannot be devised. Because scientific knowledge of MRS A is expanding and infection control guidelines are evolving, the knowledge level of healthcare workers must be assessed. Knowledge may not reflect the most current information available (Forbes 2007, p.48).

Statement of the Problem

The problem is that the prevalence of MRSA continues to increase dramatically both inside the hospital and outside in the community, but healthcare workers continue to demonstrate poor adherence to infection control practices placing both themselves and their patients at risk of acquiring MRSA and contributing to the continued spread of MRSA. Compliance of infection control precautions is a complex issue dependent on many factors. The knowledge level of MRSA and infection control precautions by healthcare workers is just one factor that may affect infection control practices. Other factors include attitudes and beliefs about MRSA (Felkner 2007, p.289-295)

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Purpose of the study

MRS A is no longer just a ...