The Effects of Patient Education on

Reducing the Hospital Acquired

Infection MRSA
Presented By:
Amanda Christenson, Kenzie Coe,
Madison Oaks, & Maria Osornio
Opening Mindful Moment

2
Objectives

➢ Define terms associated with the hospital acquired infection

Methicillin-resistant Staphylococcus aureus, also known as MRSA
➢ Provide information regarding how implementing sufficient
patient/family education regarding the avoidance of hospital acquired
infections, specifically MRSA
➢ Review background information and literature
➢ Present evidence-based research using the Model for Improvement and
PDSA cycle

3
Summary of Case Study

➢ Whitney Ross was a sophomore in college

➢ She resulted in post-op after an appendectomy
➢ Whitney was experiencing pain from the peripheral IV place on her left
arm.
➢ After notifying her nurse, she suggested moving the IV to the other arm
and noticed a rash on her right arm which the nurse stated would not
present as an issue since the IV site would be down by her wrist.
➢ A patient from down the hall had contracted a MRSA infection at his
surgical site which caused for a prolonged hospitalization.
➢ His daughter, Kelly, was visiting and went to the nurses’ desk to ask for an
additional pillow for Tom. When she did, she approached the nurses
station while she was still wearing a pair of contaminated gloves from
Tom’s room.
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Summary of Case Study

➢ Dena failed to educate the patient’s family about HAIs and did not decontaminate
the surface that Kelly touched with the contaminated gloves before Whitney’s nurse
approached the nurses’ station and touched the same surface.
➢ Nathan failed to lay the foundation for a safe effort regarding infection control which
led to Whitney’s nurse not being well-informed and did not perform hand hygiene
and followed by removing her gloves while she removed Whitney’s existing IV
➢ Whitney began exhibiting symptoms of an infection and her worsening vital signs
were overlooked by Dr. Kennedy, Manuel, and each nurse that looked after
Whitney’s care
➢ By the time Whitney reached the ICU, she was suffering from organ failure as a result
from sepsis.
➢ Whitney died from the MRSA infection from a lack of infection prevention and
communication
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 Definitions

Term Definition

HAI Health-associated infections are infections that develop as a result of health care
provided for another condition (health, n.d.)

MRSA Methicillin-resistant Staphylococcus aureus (MRSA) is a type of staph infection that

is typically difficult to treat because of the resistance to some antibiotics (CDC,
2019)

Four Phases of a QI project 1. Innovation, 2. Pilot, 3. Implementation, 4. Spread (IHI, n.d.)

Run Chart Displays data to enhance an understanding of the numeric values in order to
improve (Williams & Little, 2020)

Common Variation Inherent to the system or process, results from regular, natural, or ordinary causes
(Williams & Little, 2020)

Special Cause Variation (QI 104) Not inherent to the design of the process; results from irregular or unnatural
causes; affects some, but not all aspects of the process (Williams & Little, 2020)
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 Background & Significance

What is the importance of infection prevention and control in

hospitals? Who should be promoting infection prevention?

➢ Infection control refers to policy and procedures put in place to control and minimize the
production of infections (Habboush, 2021)
➢ RNs and Infection Preventionists are given leaderships in healthcare settings to educate and
reduce the amount of infections developed in hospitals (Manning, 2018)
➢ RNs are well-positioned to provide patient education on patient safety, especially when referring
to infections acquired in the healthcare setting (Manning, 2018)
➢ Patients have reported a lack thereof adequate information/education regarding hospital acuired
infections such as MRSA and how to prevent them from occurring (Musuuza, 2020)
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Literature Review

8
Review and Synthesis
of Literature

Education:
➢ Inconsistencies reported with education on when and how to use preventative measures
➢ Lack of education altogether was reported in
➢ Patients received hand hygiene education from RNs and nurse techs during post-op
(Haverstick, 2017)
Patient Advocacy:
➢ Patients do not often feel as though they can ask when preventative measures are being taken
➢ Only 25% of patients reported receiving information regarding MRSA and handwashing upon
hospital admission (Hammoud, 2020)
Prevention Technique:
➢ Patients were provided with individual bottles of hand sanitizer during post-op (Haverstick,
2017)
➢ Patients often skip hand hygiene and such preventative measures as a result of being
immobilized due to a procedure or injury (Haverstick, 2017) 9
Making the Connection

➢ To Err is Human emphasized the need for patient safety

and the importance of patient communication and
education
➢ Severe complications can arise
➢ Errors can affect patients as well as family members
➢ Death can be caused by skipping over a simple step
➢ There is a necessity for change within the healthcare
system to prevent the development of any healthcare
associated infections

10
Concept Map &
IN Applications

11
12
 Patient & Informatics
Complex Adaptive Systems
Systems within Systems⁵
(CAS)

Not
Functioning
Functioning

1. Effective interoperability 1. Poor interoperability

2. Monitors data and notifies when

2. Threatens patient safety
rates are increasing (HAIs, days with
catheter etc)
3. Delays effective treatment
3. Timely notification of lab/imaging
results (ex. C&S for antibiotic
selection) 4. Allows for mistakes
4. Acts to catch mistakes before they
happen (ex. scanning for correct
patient)

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Safety & Quality Issues

01
Lack of education on proper
glove use and infection
prevention given to patients.

02
Team approach was not
implemented and infection
prevention specialist did not
have the skills needed for her
position.
Integrative Nursing Principles

INP #4
Integrative nursing is
person-centered and
relationship-based.⁹

INP #6
Integrative nursing focuses on
the health and well being of
caregivers as well as those they
serve.⁹
QI Project & Rationale

We chose to focus our project on improved

Project education on infection prevention,

specifically focusing on education given to
patients and their family members.

Appropriately educated patients and family

members can help to prevent the spread of

Rationale
infection. Quality education allows the patient
to play an informed role as a member of the
healthcare team as well as contribute to the
safety of others in the hospital.
 Model for
Improvement

17
 Model For Improvement PDSA⁸

1. What are we trying to accomplish?

Act Plan
2. How will we know that a change is an
improvement?

3. What change can we make that will result

in improvement?⁸ Study Do

Used as a framework or guide for Used for implementing and re-evaluating

improvement changes.
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The effects of patient education on reducing hospital acquired bacterial infections

Project Objectives Healthcare Issue Recommended for Improvement

Learning Goal

❖ Qualitative:
➢ Do patients feel more equipped to
deal with their HAI’s with the
education provided? ❖ Patient education for MRSA to reduce
infection rates on ABC unit of XYZ setting
❖ Quantitative:
➢ Does patient education with verbal
and written information on
infection control decrease the
incidence of hospital acquired MRSA
infections?

19
Slide 17 “Project Objectives” continued...

What questions we intend to answer:

❖ Qualitative
➢ How do the nurses describe the experience of delivering the
educational teaching on MRSA HAI’s? What barriers to education did
they encounter?

❖ Quantitative
➢ Does patient education with verbal and written information on
infection control decrease MRSA infection rates on ABC unit of XYZ
setting?

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PDSA - plan
Key Process Measures: Change of incidence in hospital
acquired MRSA infections with education
Quantitative Data: Decreased incidence of hospital
acquired MRSA on unit Y over 24 days.
Qualitative Data: Nurses experience delivering
education on MRSA HAIs as well as barriers to
education encountered?
Data Collection:
Written and video education on MRSA HAIs will be given
to patients on an ICU floor in unit Y at one local hospital.
Testing will take place between October 24, 2021 -
November 17, 2021
This study will be implemented by nurses, CNAs, and the
floors nurse educators.
Analyze & Share Findings:
Data will be collected by the charge nurse at the end of
each day and be reported back to nurse educator for
analysis.
If results show improvement they will be implemented
on the entire floor.
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PDSA - do

Expected Results:

1. Rates of MRSA HAI will decrease over time with education.

2. Nurses will encounter and recognize barriers to education. The education will be
adjusted to overcome these barriers and reimplemented.

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Run Chart Analysis

Please see next slide for run chart

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24
Run Chart Analysis

What that component

Run Chart Component Absent or Present
tells us

6 or more consecutive KEY FINDINGS:

Shifts points above or below 1
the median ● The run chart is
indicating that change is
5 or more sequential occurring
Trends data points all going up Absent
or down ● The overall number of
HAI’s has generally
One or more decreased
consecutive data points
Number of runs 7
on the same side of the
median

Data points that stand

Astronomical points out as far away from Absent 25
others
PDSA
Predictions Theoretical Findings

Quantitative Education decreased MRSA HAI in

Patient Education about MRSA will the hospital
decrease the incidence of this HAI

Qualitative Patient will feel more included and
empowered in their responsibility for their
own health after receiving clear
education about their infection
Patients were autonomous in their
care and understood education.
They participated in correct aseptic
technique which decreased MRSA
in the hospital

Summary: Our change did theoretically lead to an improvement and a substantial decrease in hospital
acquired infections compared to before providing patient education. Providing patient education to
reduce hospital acquired infections lead to a decrease in HAI.

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PDSA

We will do further testing and documentation on patients who have

been given patient education on avoiding/preventing hospital
acquired infections to track how much HAIs have decreased and
accommodate the teaching necessary for each patient.  

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 Summary, Questions to
Class, Reflections & Pearls

28
SUMMARY Team Feedback
● Increased collaboration
● Active involvement
● Clear expectations of each other
● Engaging topic
● Great learning experience to apply to clinical
practice

Integrative Nursing

1. IN #5
2. IN #6

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Discussions 2. What integrative
nursing principle
most closely aligns
with providing
effective education?

Questions
1. In what ways can nurses
be influential in
encouraging
widespread compliance
in handwashing?

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Reflection

-Engaging topic
-Zoom meetings
FACILITATORS -Shared pride in
work

-Schedule
conflicts
-Time constraint
-Communication BARRIERS
-Life events

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Pearls of Wisdom 1. Don’t forget to laugh and
have fun with your team
while working on the
project

5. Do not leave the 2. Watch and rewatch the

video portion until video. You can miss some
important details the first
the last minute
time around

4. Restate the IN principles in

question form
3. Be creative & make the
(I.E. Does the health and wellbeing of
presentation your own
caregivers influence (your topic)?

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Closing Mindful Moment

I I I I
_______________

Ask yourself: In this moment are you being Mindful or Mind Full?
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 References
Centers for Disease Control and Prevention. (2019, February 5). MRSA. Centers for Disease Control and Prevention. Retrieved from

https://www.cdc.gov/mrsa/index.html.

Eisenberg, M. (Director). (2019). To err is human [Film]. Kanopy.

Giddens, J. F. (2019). Concepts for nursing practice e-book (3rd ed.). Mosby.

Habboush, Y. (2021, September 13). Infection control. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK519017/.

Hammoud, S., Amer, F., Lohner, S., & Kocsis, B. (2020). Patient education on infection control: A systematic review. American Journal of Infection Control,

48(12), 1506–1515. https://doi.org/10.1016/j.ajic.2020.05.039

Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017). Patients’ hand washing and reducing hospital-acquired infection.

Critical Care Nurse, 37(3). https://doi.org/10.4037/ccn2017694

Health care-associated infections. health.gov. (n.d.). Retrieved from

https://health.gov/our-work/national-health-initiatives/health-care-quality/health-care-associated-infections.

Institute for Healthcare Improvement. (n.d.). QI 104: The life cycle of a quality improvement project. Institute for Healthcare Improvement. Retrieved

from http://www.ihi.org/education/ihiopenschool/Pages/default.aspx.

Kreitzer, M.J., Koithan, M. (2018) Integrative Nursing (2nd ed). FA Davis Company. https://bookshelf.vitalsource.com/#/books/9780190851064/
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 References Cont.
Manning, M. L., & Pogorzelska-Maziarz, M. (2018). Health care system leaders' perspectives on infection preventionist and registered nurse engagement in antibiotic

stewardship. American journal of infection control, 46(5), 498–502. https://doi.org/10.1016/j.ajic.2017.10.024

Musuuza, J. S., Roberts, T. J., Hundt, A. S., Carayon, P., Zimbric, M. L., Schuetz, V., Reppen, M., Smith, W., Koffarnus, K., Brown, R. L., Bowling, J., Jalali, K., & Safdar, N.

(2020). Implementing daily chlorhexidine gluconate treatment for the prevention of healthcare-associated infections in non-intensive care settings: A

multiple case analysis. PloS one, 15(4), e0232062. https://doi.org/10.1371/journal.pone.0232062

Science of improvement: Implementing changes: IHI. Institute for Healthcare Improvement. (n.d.). Retrieved from

http://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementImplementingChanges.aspx.

University of Minnesota. (2021). Principles of integrative nursing. Center for Spirituality and Healing - University of Minnesota. Retrieved from

https://www.csh.umn.edu/education/focus-areas/integrative-nursing/principles-integrative-nursing

Williams, D., & Little, K. (2020). Lesson 2: How to Learn from Run Charts and Control Charts, In L. Fink & M. Briddon (Eds.), QI 104: Interpreting Data: Run Charts,

Control Charts, and Other Measurement Tools.

https://education.ihi.org/topclass/topclass.do?CnTxT-139783372-contentSetup-tc_student_id=139783372-item=3259-view=1.

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Images Used

◂ Slide 2:
https://i.pinimg.com/originals/37/81/53/37815389703655d74c527b6360fad
1d3.png

◂ Slide 10
https://www.modernhealthcare.com/article/20181103/NEWS/181109992/to-err-is
-human-documentary-explores-deadly-medical-errors

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