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PubMedDate not supplied

Minnesota plan for nonsmoking and health: multidisciplinary approach to risk factor control.

In 1981, the Minnesota Department of Health began a long-term program to control risk factors for the major health problems of the State as determined by an expert committee. The methods chosen to initiate programs were social, economic, and epidemiologic background research and a multidisciplinary statewide planning process. Smoking was considered the most important problem. During 1983-84, department staff members analyzed the epidemiology and economics of smoking in Minnesota and reviewed the literature on methods of smoking control. They and a multidisciplinary technical committee prepared a coordinated plan to increase the prevalence of nonsmoking in Minnesota. The 39 recommendations address mass communication and marketing, educational programs in schools, public and private regulation, economic disincentives through taxation, and funding of programs and evaluation of results. The Minnesota Plan for Nonsmoking and Health was released in September 1984. During the first half year, the plan provided material for formation of a coalition of health organizations to promote nonsmoking. In June 1985, the Minnesota Legislature passed the Omnibus Nonsmoking and Disease Prevention Act, which provides $4 million over 2 years for promotion of nonsmoking through education, regulation, and public communications. These intervention activities will be funded by a portion of a 5-cent increase in cigarette excise tax. The foundations have been laid for what may be the most comprehensive statewide nonsmoking program in the United States.

Adolescent↗
PubMed1987

Prospective surveillance of Haemophilus influenzae type b disease in Dallas County, Texas, and in Minnesota.

Among children less than 12 years of age residing in Dallas County, Texas, and in the state of Minnesota we conducted prospective, active surveillance of invasive Haemophilus influenzae disease. During 18 months, 616 cases were identified, of which 600 were caused by type b organisms. The annual incidence of disease was significantly greater in Dallas than in Minnesota (109 v 68/100,000 children younger than 5 years of age, P less than .001) and was greater in Dallas, even when rates for white children in the two regions were compared (P less than .001). Other regional differences were observed. In Dallas, a larger proportion of cases were in children attending day-care centers (27% compared with 12% in Minnesota, P less than .001) and more patients attended day care for greater than 40 h/wk (56% compared with 30% in Minnesota, P less than .001). Outer membrane protein subtyping of isolates revealed that in Dallas 6U isolates were associated significantly with cases in black children who attended day care. In Minnesota, but not in Dallas, isolates with subtype 1H were associated significantly with cases in children in day care. These data indicate that there are regional differences in the epidemiology of type b Haemophilus disease that may relate to differences in strains, day-care practices, or other unknown cultural or environmental factors. Finally, because only 15% of systemic Haemophilus disease in these regions occurred in children in the age groups recommended for vaccination (24 to 59 months), the new Haemophilus type b polysaccharide vaccine is expected to have a limited impact on the overall incidence of disease.

Bacterial Outer Membrane Proteins↗
PubMed1996

Data organizations and data networks in Minnesota.

The state of Minnesota offers examples of data-driven organizations as well as a statewide effort to electronically link these into an integrated network. The examples provided by Blue Cross Blue/Shield of Minnesota demonstrate an array of analytical tools to improve quality and enhance financial performance. Blue Cross/ Blue Shield of Minnesota uses a clinical severity measurement system to aid in the development of an inpatient hospital reimbursement methodology which enables hospitals to better manage the quality of care delivered to the patient population. They also make use of population-based utilization analysis in a collaborative environment with providers to improve quality and efficiency of care. The Minnesota Health Data Institute was created by the state legislature to support the information needs of the health care stakeholders in Minnesota. One of its first initiatives is to develop a uniform method of comparing health care plans.

Computer Communication Networks↗
PubMed1997

A decentralized, community-based design for statewide immunization registries in Minnesota.

Incomplete immunization records and an increasingly complex immunization schedule make it difficult for parents and providers to know what shots their children or clients need. Complete and accurate immunization records are needed for day care, sports, camp, and school, but this is difficult--especially when previous immunizations have been received at different clinics. Population-based immunization registries help make complete and accurate records more easily available to parents and health care providers. Registries foster the timely sending of reminder notices for children who are due for immunizations and make it possible for providers to quickly assess immunization rates in their clinic. Public health officials use registries to determine immunization rates, to identify pockets of need where immunization rates are low and to target resources. In Minnesota, over 85% of immunizations are delivered in the private sector. Minnesota is also extensively covered by managed care organizations with an estimated 75% of the total population enrolled in some type of managed care. Strong local community public health agencies in each county also drive local solutions to community needs. These factors and others led to a de-centralized approach to the implementation of registries. The "Minnesota Model" is based on the development of community-based registries which link together local clinics, hospitals, health plans, public health departments, and schools in each region. Each community-based registry is designed to link to a state hub. This decentralized open architecture design is based on standards for data, not hardware or software. The building begins, not by implementing a state registry into which all immunizations are entered, but at the community level. Currently, 38% of Minnesota counties (representing 52% of statewide births) are involved in implementing a community-based registry, and 53% (representing 43% of statewide births) have initiated discussions with private providers. Only 9% of counties (5% of statewide births) have no current registry activity. This paper describes the steps which have been taken towards developing a decentralized statewide immunization information system for Minnesota, based on recommendations put forth by The State Immunization Practices Task Force Work Group on Immunization Registries.

Child↗
PubMed1997

Waddell's nonorganic signs and Minnesota Multiphasic Personality Inventory profiles in patients with chronic low back pain.

STUDY DESIGN: An analysis of clinical data gathered at an orthopedic outpatient clinic is presented. OBJECTIVE: To examine the relationship between Waddell scores and the Minnesota Multiphasic Personality Inventory response patterns. SUMMARY OF BACKGROUND DATA: Waddell's study of nonorganic signs of low back pain showed consistent correlations with Minnesota Multiphasic Personality Inventory scales 1 to 3. METHODS: A Waddell score was obtained from 507 consecutive patients with chronic low back pain to whom an Minnesota Multiphasic Personality Inventory also was administered. The sample was divided into those patients with a high Waddell score (high waddell score = 3 to 5) and those with a low Waddell score (low waddell score = 0 to 2); men and women were scored separately. RESULTS: Among male patients, statistically significant differences were found between the high Waddell score and low Waddell score groups on Minnesota Multiphasic Personality Inventory scales, 1, 3, and 8, but among females, differences were statistically significant only on scale 8. CONCLUSIONS: Correlations between the Waddell score and the first three scales of the Minnesota Multiphasic Personality Inventory were not fully replicated. The difference between the high Waddell and low Waddell groups on scale 8, however, was significant for men and women.

Adult↗
PubMed2006

The Irvine-Minnesota inventory to measure built environments: reliability tests.

BACKGROUND: Inter-rater reliability is an important element of environmental audit tools. This paper presents results of reliability tests of the Irvine-Minnesota Inventory, an extensive audit tool aimed at measuring a broad range of built environment features that may be linked to active living. METHODS: Inter-rater reliability was measured by percentage agreement between observers. Reliability was tested on a broad range of sites in both California and Minnesota. RESULTS: For the variables that remained in the inventory, in tests conducted at the University of California-Irvine, 76.8% of the variables had >80% agreement among the three raters. In tests conducted at the University of Minnesota, 99.2% of the variables had >80% agreement among the two raters. CONCLUSIONS: Reliability was high for most items. The inventory was modified to eliminate items with low reliability. Differences in the use of the inventory and the goals of the research led to generally higher reliability in Minnesota. Those differences, limitations, and directions for future research are discussed.

California↗
PubMed2004

Drought planning and water allocation: an assessment of local capacity in Minnesota.

Water allocation systems are challenged by hydrologic droughts, which reduce available water supplies and can adversely affect human and environmental systems. To address this problem, drought management mechanisms have been instituted in jurisdictions around the world. Historically, these mechanisms have involved a crisis management or reactive approach. An important trend during the past decade in places such as the United States has been a shift to a more proactive approach, emphasizing drought preparedness and local involvement. Unfortunately, local capacity for drought planning is highly variable, with some local governments and organizations proving to be more capable than others of taking on new responsibilities. This paper reports on a study of drought planning and water allocation in the State of Minnesota. Factors facilitating and constraining local capacity for drought planning were identified using in-depth key informant interviews with state officials and members of two small Minnesota cities, combined with an analysis of pertinent documentation. A key factor contributing to the effectiveness of Minnesota's system is a water allocation system with explicit priorities during shortages, and provisions for restrictions. At the same time, the requirement that water suppliers create Public Water Supply Emergency Conservation Plans (PWSECP) clarifies the roles and responsibilities of key local actors. Unfortunately, the research revealed that mandated PWSECP are not always implemented, and that awareness of drought and drought planning measures in general may be poor at the local level. From the perspective of the two cities evaluated, factors that contributed to local capacity included sound financial and human resources, and (in some cases) effective vertical and horizontal linkages. This analysis of experiences in Minnesota highlights problems that can occur when senior governments establish policy frameworks that increase responsibilities at the local level without also addressing local capacity.

Conservation of Natural Resources↗
PubMed2006

Characterization of Minnesota dairy herds participating in a Johne's disease control program and evaluation of the program risk assessment tool.

The objectives of this study were to: (1) characterize Minnesota dairy herds participating in a Johne's disease control program (JDCP) based on herd size, milk production, and clinical Johne's disease (JD) history, (2) evaluate if change in farm management practices, expressed in risk assessment (RA) total score, is associated with the change between the first and most recent ELISA test herd seroprevalence or change in clinical JD culling rate, and (3) identify farm factors associated with ELISA seroprevalence. A total of 1234 RA, performed between January 2000 and February 2004, were available for analysis from 714 dairy herds. ELISA test results from herd sampling between 2000 and 2004 were obtained from the Minnesota board of animal health (MBAH) database, and were available for 474 herds. Both the first and the most recent ELISA test results for herds with more than one RA were available for 262 herds. Mean herd size and mean annual milk production per cow was higher in JDCP dairy herds (161 milking cows) than either all Minnesota dairy herds or Minnesota dairy herd improvement association (DHIA) herds. For herds with more than one RA available, the most recent RA total score was significantly lower (mean 11% less) than the first. The change in RA total score (and any RA subtotal scores) between the first and most recent RA was not associated with the change between the first and the most recent ELISA within-herd seroprevalence or the change in JD culling rate between the first and most recent RA. The most recent ELISA test results were positively associated with postweaned heifer score and JD culling rate. The RA score was not found to be an effective tool for the prediction of ELISA seroprevalence.

Animal Husbandry↗
PubMed1998

Comparison of 3 methods for counting fruits and vegetables for fourth-grade students in the Minnesota 5 A Day Power Plus Program.

OBJECTIVE: To compare fruit and vegetable servings calculated from 24-hour dietary recall data using 3 methods: a counting scheme developed for the 5 A Day for Better Health study, a method developed by the University of Minnesota Cancer Prevention Research Unit to quantify total consumption of fruits and vegetables, and a counting scheme based on the US Food and Drug Administration's Reference Amounts. The counting methods differ by food items counted and by serving sizes for those items. SUBJECTS/SETTING: Record-assisted 24-hour dietary recalls were collected from 617 randomly selected fourth-grade students (317 girls, 300 boys) from 23 schools in St Paul, Minn, participating in the Minnesota 5 A Day Power Plus Program. DESIGN: The dietary recalls were analyzed using the Minnesota Nutrition Data System (version 2.6/8a/23). Total servings of fruits and vegetables, servings of vegetables, servings of fruits plus juices, servings of fruit juice, and servings of fruit excluding juice were tallied using each counting method. STATISTICAL ANALYSES: A mixed-model Poisson regression analysis was conducted to compare numbers of servings calculated using the 3 methods. RESULTS: Counts of daily total fruits and vegetables averaged 3.9 servings with the 5 A Day method, 4.1 servings using US Food and Drug Administration Reference Amounts, and 5.1 servings with the Minnesota Cancer Prevention Research Unit method (P < .0001). APPLICATIONS: Because the different counting methods yield different tallies of fruit and vegetable intake, it is important for researchers and practitioners interested in fruit and vegetable consumption to be clear about their uses of the data before choosing a counting scheme.

Child↗
PubMed1996

A survey of tuberculosis control programs in seventeen Minnesota hospitals: implications for policy development.

BACKGROUND: Generation of proposed policies directed at interrupting the transmission of Mycobacterium tuberculosis resulted in a need for data establishing health care worker (HCW) tuberculosis (TB) transmission risk and control programs that were in place before 1992. METHODS: A voluntary sample of 18 Minnesota health care facilities was surveyed retrospectively for the years 1989 to 1991. The survey was designed to establish the frequency of positive tuberculin skin test (TST) results, the rate of positive results during routine screening, the incidence of positive TST results identified through exposure follow-up, the type of respiratory protection (mask) used, and ventilation patterns of TB isolation rooms. The TST testing program, including name of product used, method of application, and reading/documentation behaviors, was requested. RESULTS: Data were analyzed from 17 hospitals (one long-term facility was deleted). Three hospitals screened all HCWs annually; the remaining hospitals screened HCWs at varying intervals. Forty-eight positive TST results were identified in routine screening. The rate per 10,000 HCWs screened was 5.8 in 1989; 15.9 in 1990; and 14.8 in 1991. An upward trend was noted in positive TST results only in metropolitan teaching/public hospitals. Intercomparisons of TST screening data demonstrated that employees located in Greater Minnesota were more likely to have positive TST results than employees at facilities in the metropolitan area. Hospitals in Greater Minnesota were more likely than metropolitan area hospitals to use tuberculin skin test material. HCWs screened with tuberculin purified protein derivative were more likely to have positive test results than HCWs screened with tuberculin purified protein derivative. Unisolated patients with communicable TB accounted for 445 patient days of probable risk of exposure for HCWs, without demonstration of a trend by calendar year. There were a total of 33 exposure events. Ten of 1031 HCWs screened after an exposure event were declared to be TST positive, for an overall conversion rate of 9.7 per 1000 employees screened. All hospitals used surgical masks for respiratory protection. Seventy-six percent of the hospitals had isolation rooms with negative ventilation; 12% reported isolation rooms with neutral pressure. CONCLUSION: The practice in Minnesota hospitals surveyed was reasonably consistent with the critical elements defined in the 1990 CDC guidelines for an effective TB control program. The rate of positive TST results was low, with programs in place before 1992. Unified TST programs permitting evaluation of programs are endorsed. Respiratory protection should be protective, not excessive. Engineering controls of isolation rooms should be ensured. Policy development should be driven by the prevalence and incidence of disease in the HCW's place of employment.

Adult↗
PubMed1999

Quinolone-resistant Campylobacter jejuni infections in Minnesota, 1992-1998. Investigation Team.

BACKGROUND: Increasing resistance to quinolones among campylobacter isolates from humans has been reported in Europe and Asia, but not in the United States. We evaluated resistance to quinolones among campylobacter isolates from Minnesota residents during the period from 1992 through 1998. METHODS: All 4953 campylobacter isolates from humans received by the Minnesota Department of Health were tested for resistance to nalidixic acid. Resistant isolates and selected sensitive isolates were tested for resistance to ciprofloxacin. We conducted a case-comparison study of patients with ciprofloxacin-resistant Campylobacter jejuni isolated during 1996 and 1997. Domestic chicken was evaluated as a potential source of quinolone-resistant campylobacter. RESULTS: The proportion of quinolone-resistant C. jejuni isolates from humans increased from 1.3 percent in 1992 to 10.2 percent in 1998 (P<0.001). During 1996 and 1997, infection with quinolone-resistant C. jejuni was associated with foreign travel and with the use of a quinolone before the collection of stool specimens. However, quinolone use could account for no more than 15 percent of the cases from 1996 through 1998. The number of quinolone-resistant infections that were acquired domestically also increased during the period from 1996 through 1998. Ciprofloxacin-resistant C. jejuni was isolated from 14 percent of 91 domestic chicken products obtained from retail markets in 1997. Molecular subtyping showed an association between resistant C. jejuni strains from chicken products and domestically acquired infections in Minnesota residents. CONCLUSIONS: The increase in quinolone-resistant C. jejuni infections in Minnesota is largely due to infections acquired during foreign travel. However, the number of quinolone-resistant infections acquired domestically has also increased, largely because of the acquisition of resistant strains from poultry. The use of fluoroquinolones in poultry, which began in the United States in 1995, has created a reservoir of resistant C. jejuni.

Analysis of Variance↗
PubMed2000

The impact of foodborne calicivirus disease: the Minnesota experience.

The first outbreaks of Norwalk virus gastroenteritis in Minnesota were confirmed in 1982. Since then, Norwalk-like caliciviruses have been recognized to be the most common cause of foodborne disease outbreaks, accounting for 41% of all confirmed foodborne outbreaks in Minnesota from 1981-1998. Although laboratory confirmation of caliciviruses in stool samples was not attempted in most of these outbreaks, all conformed to epidemiologic criteria for defining outbreaks of Norwalk virus. Since 1996, the availability of polymerase chain reaction testing at the Minnesota Department of Health has allowed for the confirmation of calicivirus infection among patients involved in epidemiologically defined outbreaks of viral gastroenteritis. Results have confirmed the usefulness of characterizing foodborne disease outbreaks by epidemiologic criteria and also confirmed the importance of human caliciviruses as the leading cause of foodborne disease outbreaks in Minnesota.

Caliciviridae Infections↗
PubMed1992

Invasive Haemophilus influenzae type b disease in children less than 5 years of age in Minnesota and in Dallas County, Texas, 1983-1984.

During 1983 and 1984, 733 cases of invasive Haemophilus influenzae type b disease in children less than 5 years of age were identified in Minnesota and in Dallas County, Texas. The overall incidence of disease was lower in Minnesota than in Dallas County. However, among urban residents, the rates of disease for whites were similar in the two areas. A higher rate of disease among whites in urban Minnesota compared with rural Minnesota resulted from an increased rate of cases for diagnoses other than meningitis. Local practices might have affected the rate of certain diagnoses, since ascertainment of Hib disease other than meningitis is more dependent on diagnostic practices than is diagnosis of meningitis. These data suggest that the incidence of invasive H. influenzae type b disease is influenced by the racial composition of the population, the rates of disease in specific subgroups, and possibly by local medical practices. Understanding the factors that contribute to the incidence of disease is necessary to interpret variations in different populations and changes over time.

Age Factors↗
PubMed1997

Fecal occult blood screening in the Minnesota study: role of chance detection of lesions.

BACKGROUND: In the Minnesota Colon Cancer Control Study, annual fecal occult blood testing reduced mortality from colorectal cancer by at least 33.4%. Some attribute a large part of this reduction to chance detection of cancers by colonoscopies; rehydration of guaiac test slides greatly increased positivity and consequently the number of colonoscopies performed. This study was conducted to determine how much of the reduction resulted from chance detection. METHODS: We used a mathematical model developed by Lang and Ransohoff to estimate the proportion of the 33.4% mortality attainable by chance alone. Applying the model requires the specification of five parameters: duration of follow-up, rate of compliance with fecal occult blood testing, rate of compliance with colonoscopy, positivity rate, and efficacy of colonoscopy in reducing colorectal cancer mortality. We took values for four of the five parameters directly from the Minnesota study. For the fifth parameter, efficacy of colonoscopy, we selected a value of 60%, based on the conclusions of another study. Whereas the Lang-Ransohoff model selects persons for colonoscopy by chance alone, those with bleeding cancers would also be selected by sensitive fecal occult blood testing. We therefore adjusted the result of the Lang-Ransohoff model for this dual detectability. RESULTS: We found that 16%-25% of the reduction in colorectal cancer deaths effected by fecal occult blood testing in the Minnesota study was due to chance detection; the remainder was due to sensitive detection. CONCLUSION: Chance played a minor role in the detection of colorectal cancers by fecal occult blood testing in the Minnesota study.

Aged↗
PubMed1997

Fecal occult blood screening in the Minnesota study: sensitivity of the screening test.

BACKGROUND: In the Minnesota Colon Cancer Control Study, which used guaiac slides to annually screen stool samples for blood, mortality from colorectal cancer was reduced by 33.4%. The reported sensitivity of this test for colorectal cancer was about 90%. However, results from another study estimated the sensitivity to be 25%-33%; other investigators have reported intermediate values. Given these contradictions, we examined screening sensitivity for colorectal cancer in the Minnesota study by several direct and indirect methods. METHODS: In this reanalysis of data from the Minnesota study, we distinguished between sensitivity for colorectal cancer of the screening test (composed of six slides) and of the screening program (a series of such tests). We estimated screen sensitivity by adjusting the crude estimate from the final tests in each screening phase for colorectal cancer incidence in 5 years of follow-up, by modeling guaiac slide results at each screen as a function of the presence of occult blood, and by incorporating sensitive detection into a modification of a mathematical model developed by Lang and Ransohoff. Program sensitivity was estimated from the fraction of screen-detected cancers among all cancers diagnosed in screened individuals. RESULTS: The crude estimate of program sensitivity was 89.4%, whereas the modified Lang-Ransohoff model estimates screen sensitivities at 94.1%-96.2%, consistent with the estimates from the other methods. Indirect measures, such as the association between the number of positive slides among the six slides in each set and the positive predictivity for colorectal cancer, are consistent with these estimates. CONCLUSIONS: The Minnesota study reduced mortality from colorectal cancer through use of a screening test with average screen and program sensitivities of about 90%.

Colorectal Neoplasms↗
PubMed1994

Physician attitudes and practices regarding universal infant vaccination against hepatitis B infection in Minnesota: implications for public health policy.

Physician attitudes and practices regarding universal infant vaccination against hepatitis B virus infection in Minnesota were assessed approximately 1 year after publication of the Immunization Practices Advisory Committee recommendations. Four-hundred eighteen Minnesota family physicians and pediatricians were sent self-administered questionnaires, with follow-up by telephone. Among physicians who provide care to infants, 67 (29%) of 234 family physicians and 29 (50%) of 58 pediatricians routinely offered hepatitis B vaccine to all infants (overall 33%) (P = 0.002). The recommendations of the Immunization Practices Advisory Committee, the American Academy of Pediatrics and the American Academy of Family Physicians had the greatest positive influence on physicians' opinions regarding routine hepatitis B vaccination. The factors with the greatest negative influence on their opinions were the low prevalence of hepatitis B virus infection in Minnesota and the addition of three injections to the current childhood immunization schedule. Universal infant hepatitis B vaccination remains controversial among Minnesota family physicians and pediatricians. We believe, given the variability in hepatitis B virus incidence and prevalence in the United States and the relatively low risk of most infants, that a single national policy based solely on universal infant immunization may be difficult to implement.

Adult↗
PubMed1998

Hepatitis B infection in Minnesota: a case for universal immunization.

BACKGROUND: In 1993, the Minnesota Department of Health focused on using multiple vaccination strategies to prevent the transmission of hepatitis B virus. METHODS: Strategies aggressively pursued included the universal screening of pregnant women for hepatitis B surface antigen (HBsAg) and the universal vaccination of infants and adolescents. Universal strategies were deemed necessary because previous selective vaccination of high risk groups had failed to significantly reduce hepatitis B transmission. RESULTS: Surveillance data showed that in Minnesota from 1994 to 1996, the universal HBsAg screening of pregnant women identified 761 infants born to HBsAg-positive women. The vast majority of these at risk infants received prophylactic treatment and were vaccinated at birth. Vaccination coverage was 78% (+/-4.2%, 95% confidence interval) for children ages 19 to 35 months who were born between August, 1993, and November, 1995. Most counties in Minnesota rarely report any cases of hepatitis B, and since 1991, less than 100 acute cases per year have been reported for the entire state. CONCLUSIONS: The Minnesota Department of Health has demonstrated that implementation of universal hepatitis B vaccination strategies can be successful among a generally low risk population.

Adolescent↗
PubMed1991

Methicillin-resistant Staphylococcus aureus in Minnesota nursing homes.

OBJECTIVE: To assess the experience of Minnesota nursing homes with methicillin-resistant Staphylococcus aureus (MRSA) and the policies and procedures used for its control. DESIGN: A 12-question survey, with primarily categorical responses, was mailed to the Directors of Nursing of all Minnesota long-term-care facilities. A follow-up mailing was sent to non-responders 5 weeks later. The mailing included a cover letter, a description of the study and its purposes, and a stamped return envelope. Four weeks after the second mailing, all non-responding institutions were contacted by telephone and invited to participated by mail or by completing the survey by telephone. SETTING: All long-term-care facilities in Minnesota licensed for skilled and intermediate care. PARTICIPANTS: The survey was directed to the Directors of Nursing of the long-term-care facilities with the request that, if another individual was better able to complete it, the survey be forwarded to them. RESULTS: Completed responses were obtained from 88% (395/445) of all long-term-care facilities in Minnesota. Forty-eight institutions (12%) had residents colonized or infected with MRSA. Only four (8%) of these facilities stated that MRSA was a problem; however, 33 (69%) of facilities with MRSA had sought outside help or consultation from a variety of sources for its control. Few facilities (7%) had cultured residents specifically for MRSA. Policies regarding the admission of colonized or infected persons were reported by 14% and 21% of facilities, respectively, and over 40% of these policies stated that persons with MRSA would not be accepted. Policies regarding the care of MRSA-colonized or -infected persons were not uniform. Both metropolitan and non-metropolitan facilities had residents with MRSA. CONCLUSIONS: Our results suggest that MRSA in long-term-care facilities may be a widespread and underrecognized problem. There is a need to develop uniform policies for the control of MRSA in nursing homes. These policies should consider the sources and objectives of long-term-care facilities.

Cross Infection↗