"Each hospital must do a risk assessment of its patient population and units and evaluate the study carefully and decide what works best in that hospital…There will be no cookie cutter approach to these changes for sure," she says. "This study does not require any hospital to change its protocol."
The study may prompt changes eventually. "It has broad implications and benefits for hospitals to move toward universal decolonization," Pugliese says. And because the research protocols used existing improvement infrastructures and personnel within those 43 hospitals to test these interventions, they "can be achieved by most hospitals."
Treating patients with mupirocin ointment rather than testing them first also avoids delays in waiting for test results, which can take several days. It also avoids isolating patients in contact precaution settings, which can adversely impact patient safety, Pugliese says.
Extremely important is the fact that how well hospitals reduce MRSA colonization and infection rates will impact their future federal payment, Pugliese says.
For example, she explains, the Centers for Medicare & Medicaid Services Inpatient Quality Reporting program required hospitals to start collecting data on lab-identified MRSA as of Jan. 1, 2013. And CMS is scheduled to post first quarter 2013 results on its Hospital Compare website in December.