It all comes back to basics – A review of standard precautions in reducing MRO acquisitions

Robert Robinson 1, Maria DaCosta 1

Nepean Hospital, Kingswood, NSW, Australia


Routine surveillance in an orthopaedic ward identified an increase in VRE acquisitions over a 3 month period. The objective was to investigate and identify risk factors, then implement preventative infection prevention and control strategies in the orthopaedic ward.

Screening of all patients for multi resistant organisms (VRE and MRSA) is undertaken in the orthopaedic ward. A review of current control measures included compliance with standard and contact precautions. This included a review of hand hygiene auditing, availability of hand hygiene products, PPE compliance and environmental cleaning.
Investigations revealed that shared patient equipment also was not routinely cleaned. The orthopaedic ward had equipment that was seldom used and impeded environmental cleaning. Corrective measures were implemented which included removal of unused or less frequently used equipment, enhanced environmental cleaning and staff engagement for weekly cleaning of patient shared equipment.

Over a three month period from July to September 2015, 18 patients were identified with VRE. New VRE acquisitions had decreased by November 2015 and continue to remain low in 2016 with the implementation and ongoing commitment of the infection and prevention control strategies.

This new introduced practice by the orthopaedic ward has resulted in an overall decrease in VRE acquisitions since October 2015. The engagement from the ward staff with these control measures has also resulted in less patients being cared for in contact precautions and a determination to minimise new VRE and other MRO acquisitions.

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