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Strategies to Prevent MRSA Transmission in Community-Based Nursing Homes: A Cost Analysis

Published online by Cambridge University Press:  13 May 2016

Mary-Claire Roghmann ,
Alison Lydecker ,
Lona Mody ,
C. Daniel Mullins  and
Eberechukwu Onukwugha
Mary-Claire Roghmann*
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Geriatrics Research Education and Clinical Center, VA Maryland Health Care System, Baltimore, Maryland
Alison Lydecker
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Geriatrics Research Education and Clinical Center, VA Maryland Health Care System, Baltimore, Maryland
Lona Mody
Affiliation:
Division of Geriatric and Palliative Care Medicine, University of Michigan Medical School, Ann Arbor, Michigan; Geriatrics Research Education and Clinical Center, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
C. Daniel Mullins
Affiliation:
Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland
Eberechukwu Onukwugha
Affiliation:
Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland
*
Address correspondence to Mary-Claire Roghmann, MD, MS, University of Maryland School of Medicine, 10 South Pine Street, MTSF Room 336, Baltimore, MD 21201 ([email protected]).
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Abstract

OBJECTIVE

To estimate the costs of 3 MRSA transmission prevention scenarios compared with standard precautions in community-based nursing homes.

DESIGN

Cost analysis of data collected from a prospective, observational study.

SETTING AND PARTICIPANTS

Care activity data from 401 residents from 13 nursing homes in 2 states.

METHODS

Cost components included the quantities of gowns and gloves, time to don and doff gown and gloves, and unit costs. Unit costs were combined with information regarding the type and frequency of care provided over a 28-day observation period. For each scenario, the estimated costs associated with each type of care were summed across all residents to calculate an average cost and standard deviation for the full sample and for subgroups.

RESULTS

The average cost for standard precautions was $100 (standard deviation [SD], $77) per resident over a 28-day period. If gown and glove use for high-risk care was restricted to those with MRSA colonization or chronic skin breakdown, average costs increased to $137 (SD, $120) and $125 (SD, $109), respectively. If gowns and gloves were used for high-risk care for all residents in addition to standard precautions, the average cost per resident increased substantially to $223 (SD, $127).

CONCLUSIONS

The use of gowns and gloves for high-risk activities with all residents increased the estimated cost by 123% compared with standard precautions. This increase was ameliorated if specific subsets (eg, those with MRSA colonization or chronic skin breakdown) were targeted for gown and glove use for high-risk activities.

Infect Control Hosp Epidemiol 2016;37:962–966

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 8 , August 2016 , pp. 962 - 966
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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