Contamination & Communication: Postdischarge MRSA Decolonization and Web-Based Decision Aids in the ICU


Kieran Quinn and Emily Hughes host this week’s episode of The Rounds Table. They discuss decolonization to reduce postdischarge infection risk among methicillin-resistant Staphylococcus aureus (MRSA) carriers and the effects of a web-based decision aid for surrogate decision makers of patients with prolonged mechanical ventilation.

MRSA is the most common cause of skin, soft-tissue and procedure-related infections.  The rates of MRSA infection are highest within the first six months of hospital discharge and are a common reason for re-admission.  Emily covers a trial on comparing postdischarge hygiene education with education plus decolonization, with chlorhexidine and mupirocin, in terms of MRSA infection after one year.

Surrogate decision makers may often be making decisions in intensive care units for patients who are mechanically ventilated.  Kieran reviews a trial on whether Web-based decision aid compared to usual care improves prognostic concordance between surrogate decision makers and clinicians.

Finally, The Good Stuff segment.  Emily covers an article on the changes in productivity when scribes were used by emergency physicians in Australia. Kieran covers an article on caring for complex patients with multi morbidity.

Like what you hear?  Rate us on iTunes!  Chat with us on Twitter at @roundstable and tweet at Kieran Quinn @kieranlquinn and Emily Hughes @emmy_hughes.

The Papers

1. Postdischarge MRSA Decolonization: https://www.nejm.org/doi/full/10.1056/NEJMoa1716771

2. Decision Aid: https://annals.org/aim/article-abstract/2723395/effects-personalized-web-based-decision-aid-surrogate-decision-makers-patients

Good Stuff

1. Scribes: https://www.bmj.com/content/364/bmj.l121

2. Caring for Patients with Multiple Chronic Conditions: https://annals.org/aim/article-abstract/2722548/caring-patients-multiple-chronic-conditions

Music Credits

The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW

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