Murray D. Batt

METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) : A BRIEFING FOR ACUTE CARE HOSPITALS AND NURSING FACILITIES

The incidence of methicillin-resistant Staphylococcus aureus (MRSA) has increased in communities and in healthcare facilities in the United States since the mid-1970s. Although MRSA often is thought of as a nosocomial infection problem because it is encountered in facilities of all types and sizes, it also causes many community-acquired infections. Approaches to control of MRSA vary widely, and there is lack of agreement on the most appropriate measures to control MRSA in healthcare facilities. The wide variation in approaches is due, in part, to the lack of data establishing the efficacy of specific control measures. As a result, the approaches that have been advocated have resulted in confusing and often conflicting recommendations and control measures. In some settings, there also have been unreasonable barriers and administrative hurdles that delay or prevent the transfer of patients between acute care and nursing (extended care) facilities.

SHEA Meets With OSHA and NIOSH at White House

SHEA and Institute for Healthcare Improvement recently announced their intention to collaborate on a new educational offering, “Improving Healthcare Through Clinical Epidemiology and Quality Improve-ment.” The course will be presented at the Hilton Towers, Washington, DC, November 22-25, 1996. The SHEA collaborators who were instrumental in designing this course included Walter Hierholzer, Don Goldmann, and Ed Wong, Chair of the Education Committee. Registration information is available from the SHEA Meetings epartment, telephone 609-845-1720, fax 609-853 0411, e-mail: meetings@shea. ccmail.compuserv. com. Last year, the membership committee, led by H. Gunner Deery II, designed a survey to learn more about our organization’s membership. Based on a 52% response, we are an organization that is 90% physicians, 85% of whom are internists and 76% of whom are male. Seventy-two percent of our members stated that the size of their primary hospitals was 300 beds or more. Only 16% of the hospitals were nonteaching. Seventy-five percent of the members said they did not have long-term–care healthcare epidemiology responsibilities. Fifty-six percent were involved in quality management, 9% chairing quality management at the time of the 1995 survey. We are planning to share a more detailed analysis of the information in the June SHEA Newsletter. SHEA News

Current Events: Opportunities for Epidemiologists

PRESIDENT Bryan P. Simmons, MD/Memphis, Tennessee PRESIDENT-ELECT William J. Martone, MD/Atlanta, Georgia VICE PRESIDENT Robert A. Weinstein, MD/Chicago, Illinois PAST PRESIDENT Peter A. Gross, MD/Hackensack, New Jersey SECRETARY Dale N. Gerding, MD/Chicago, Illinois TREASURER Elias Abrutyn, MD/Philadelphia, Pennsylvania COUNCILOR Edward S. Wong, MD/Richmond, Virginia COUNCILOR Leigh G. Donowitz, MD/Charlottesville, Virginia COUNCILOR Timothy W. Lane, MD/Greensboro, North Carolina COUNCILOR John W. Froggatt, III, MD/Asheville, North Carolina THE SOCIETY FOR HEALTHCARE EPIDEMIOLOGY OF AMERICA EDITED BY GLEN MAYHALL, MD MURRAY D. BATT, MD EDWARD S. WONG, MD

Dr. James Lee Heads Effort to Attract Surgeons to SHEA

PRESIDENT Bryan E Simmons, MD/Memphis, Tennessee TRFA.WRER Elias Abrutyn, MD/Philadelphia, Pennsylvania PRESIDENT-ELE(JT William J. Martone, MD/Atlanta, Georgia COUNCILOR Edward S. Wong, MD/Richmond, Virginia VICE PRESIDENT Robert A Weinstein, MD/Chicago, Illinois COUNCIL~R Leigh G. Donowitz, MD/Charlottesville, Virginia PAST PRESIDENT Peter A Gross, MD/Hackensack, New Jersey COUNCILOR Timothy W. Lane, MD/Greensboro, North Carolina SECRETARY Dale N. Gerding, MD/Chicago, Illinois COUNCILOR John W. Froggatt, III, MD/Asheville, North Carolina

Natural Rubber Latex Reactions Follow Up Needed

PRESIDEKT Peter A. Gross, MD/Hackensack, New Jersey TRFSIJRER Elias Abrutyn, MD/Philadelphia, Pennsylvania PRESIDENT-ELECT Bryan F! Simmons, MD/Memphis, Tennessee COUNCIIDR Michael D. Decker, MD/Nashville, Tennessee VICE PRESIDENT William J. Martone, MD/Atlanta, Georgia COUNCIWR Leigh G. Donowitz, MD/Charlottesville, Virginia PAST PRESIDENT Donald E. Craven, MD/Boston, Massachusetts COUNCIL~R Timothy W. Lane, MD/Greensboro, N. Carolina SECRETARY Dale N. Gerding, MD/Chicago, Illinois COUNCIL~R H. Gunner Decry, II, MD/Petoskey, Michigan I

Job Market Opening for Hospital Epidemiologist

Based on a workshop on policy superintendent of documents as strategies for prevention, treatissues in the control of S/N 052-003-01341-O c/o PO Box ment, and the delivery of treatment. tuberculosis, March 23, 1993, the 371954, Pittsburgh, PA 1525@7954. It concludes with a summary of Office of Technology Assessment Since OTA is an analytic arm of the federal involvement in TB control (OTA) has published a Congress, the text first discusses and research and lists 391 well-documented, 15Gpage book policy options for our government references. Telephone orders are entitled The Continuing Challenge of in TB and MDRTB prevention and available at (202) 783-3238. Tuberculosis. This paperback is treatment. It proceeds to review the available for

Hospital Epidemiology: Issues in Quality of Care

9.50 from the epidemiology of TB and specific

Scheckler to Retire as Chair of the SHEA Publications Committee

When it first became available, zidovudine was referred to as AZ?: Although additional agents are now available, zidovudine (Retrovir) remains a mainstay of antiretroviral therapy. After the second episode of incorrect dispensing of azathioprine (Imuran) instead of zidovudine (Retrovir), one major teaching hospital instituted a policy of mandating a phone call to any physician who persisted in ordering zidovudine (or azathioprine) as AZT, to clarify the order. These errors of dispensing, despite published reports1 illustrate the need for each hospital to use its own data to improve processes that affect the quality of care, as opposed to relying on published reports to bring such problems to the attention of medical staff. The editors of this news page would like to know whether any of our members have encountered the situation where physician prescription of zidovudine by usage of the three letters AZT has led to the mistaken dispensing of azathioprine. Please let us know of your knowledge of any such mishaps, and the improvements that were used to prevent recurrences.

Announcing New Contracts for Clinical Practice Guidelines

The charge to the Publications Committee of SHEA is to oversee and make policy recommendations to the Board concerning all formal SHEA contracts with publishers. Over the past five years, under the soon-to-beconcluded term of Committee Chair Bill Scheckler, this has involved work with Slack, Inc., in creatively developing an improved relationship between the Society and the publisher of Infection Control and Hospital Epidemiology Since the contract was signed with Slack, Inc., in 1991, income to the Society has been substantial and is equivalent to

Proposed Rule from HCFA on Notification of Patients and HIV Testing After Receipt of Potentially HIV-Infectious Blood or Blood Products

70 per member per year. Eli Abruytn will direct the Publications Committee in 1994. In addition to its work on our His prior knowledge of the contractual relationship with publication process already has Slack, Inc., the Publications contributed greatly to our Committee has provided oversight successful negotiations with Slack, and advice for the Board for the Inc. monthly “SHEA News” page in In addition to establishing a Infection Control and Hospital satisfactory working relationship Epidemiology and for the with our publisher, the financial freestanding, quarterly SHEA arrangements negotiated in the Newsletter After his completed contract have provided the Society term, the first “SHEA News” and with an increasingly firm financial SHEA Newsletter editor, Bob base. Another important Weinstein, was replaced by accomplishment for the Publicacurrent editor, C. Glen Mayhall. tions Committee was its successful For details of the successful collaboration with Slack, Inc., in tenure of Dr. Scheckler as Chair of replacing the retiring first editor of the Publications Committee, our journal, Richard Wenzel, with watch for your December 1993 our new editor, Michael Decker. issue of the SHEA Newsletter: