1. MRSA Prevention Initiative at the Ft. Thomas VA Community Living Center (CLC) September 9, 2008 APIC Chapter 26 Continuing Education Program

2. Demographics  64 beds based in Ft. Thomas, KY  2 units (3North/3South)  Only 4 private rooms  CLC Patient Mix: Short and long term stay, rehab, respite, and end of life care

3. Demographics (continued)  Support Services: Dietary, Pharmacy, Voluntary Service, Physical/Occupational/Recreational/Speech Therapies  Other Services: Dental, Podiatry, Optometry  Nursing Staff Mix include: 11.6 RNs, 19 LPNs, 27 NAs, and 1 NP, 3 physicians  Actively involved in Cultural Transformation to move towards Patient-Centered Care

4. Planning  Goal: Prevent/control MRSA transmission  Selection of Team Members  Timeline/Implementation Dates

5. Challenges  Management support  Maintaining home-like environment  CLC off site from hospital lab

6. Challenges (continued)  Incorporating Enhanced Precautions  Reassignment of Residents  Determining best approach for resident/family education

7. Use of Precautions  Contact Precautions  Enhanced Precautions  Resident Room Placement for MRSA

8. Nasal Swabbing  Admission to facility  Transfer within facility  Discharge from facility  Repeat screening culture every 6 months minimally

9. Resident Risk Assessment  High Risk Determination  Low Risk Determination  Risk Assessment Tools

10. MRSA Education Efforts  Staff  Residents/Families  Promotion/Education Activities (fair theme, festival, games, etc.)  “Quiet Approach”

11. Questions???  For further information, contact: Karen Lipscomb, RN, BSN Karen Lipscomb, RN, BSN MRSA Prevention Coordinator MRSA Prevention Coordinator Cincinnati VA Medical Center Cincinnati VA Medical Center Karen.Lipscomb@va.gov Karen.Lipscomb@va.gov