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References for "Cow Map and MRSA".   March. 8st, 2012

Approximately one in 20 Hospitalizations develop a hospital acquired infection (HAI) amounting to 1.7 infections annually.  

HAI estimated to cause almost 100,000 deaths 

CMS only can capture 9 of 25 submitted diagnostics codes using older ICD-9 billing programs. 

Preliminary data for the state of Kentucky has found only two outbreaks of infections reported by all the acute care hospitals in the State.  One of these outbreaks was MRSA. 

Measurement of MRSA Bacteremia may not allow for effective facility comparisons.   

Only hospitals which bill using the Inpatient Prospective Payment System, report Hospital  Acquired Conditions.  Critical Access hospitals don not report HAC or use the present on admission modifier. 

Articles from California and Colorado indicate the numbers reported may be flawed.  

Two studies in major medical journals which have had a disproportionate impact on healthcare policy and have inhibited the adoption of surveillance.

1)  The JAMA-Swiss Study:--    
Kavanagh K, Abusalem S. Mounting evidence supports universal surveillance for MRSA in preoperative patients. J Am Coll Surg. 2011 Aug;213(2):335-6. PMID: 21787990.  
2)  The Star ICU Study --    . 
O‚ÄôReilly KB, Doubt cast on effectiveness of universal MRSA screening. AMA News April 26, 2011    
Farr BM, Jarvis WR. Transmission of resistant bacteria in intensive care. N Engl J Med. 2011 Aug 25;365(8):762; author reply 764-5. PMID: 21864176  

Two few nurses causes an increase in Hospital Acquired Conditions & Infections. 

Needleman,J., Buerhaus, P., Mattke, S., Stewart, M., & Zelevinsky, (2002) Nurse-staffing levels and the quality of care in hospitals. New England Journal of Medicine. 346(22),1715-22. Retrieved from