Methicillin‐Resistant Staphylococcus aureus in Minnesota Nursing Homes

Objective: To assess the experience of Minnesota nursing homes with methicillin‐resistant Staphylococcus aureus (MRSA) and the policies and procedures used for its control. Design: A 12‐question survey, with primarily categorical responses, was mailed to the Directors of Nursing of all Minnesota long‐term‐care facilities. A follow‐up mailing was sent to non‐responders 5 weeks later. The mailing included a cover letter, a description of the study and its purposes, and a stamped return envelope. Four weeks after the second mailing, all non‐responding institutions were contacted by telephone and invited to participate by mail or by completing the survey by telephone. Setting: All long‐term‐care facilities in Minnesota licensed for skilled and intermediate care. Participants: The survey was directed to the Directors of Nursing of the long‐term‐care facilities with the request that, if another individual was better able to complete it, the survey be forwarded to them. Results: Completed responses were obtained from 88% (395/445) of all long‐term‐care facilities in Minnesota. Forty‐eight institutions (12%) had residents colonized or infected with MRSA. Only four (8%) of these facilities stated that MRSA was a problem; however, 33 (69%) of facilities with MRSA had sought outside help or consultation from a variety of sources for its control. Few facilities (7%) had cultured residents specifically for MRSA. Policies regarding the admission of colonized or infected persons were reported by 14% and 21% of facilities, respectively, and over 40% of these policies stated that persons with MRSA would not be accepted. Policies regarding the care of MRSA‐colonized or ‐infected persons were not uniform. Both metropolitan and non‐metropolitan facilities had residents with MRSA. Conclusions: Our results suggest that MRSA in long‐term‐care facilities may be a widespread and underrecognized problem. There is a need to develop uniform policies for the control of MRSA in nursing homes. These policies should consider the sources and objectives of long‐term‐care facilities. 1991 The American Geriatrics Society