Point-of-care MRSA tests of trauma patients offer trust-wide benefits

Infection control is critical in all aspects of healthcare, and fast methicillin-resistant Staphylococcus aureus (MRSA) polymerase chain reaction (PCR) testing at the point of patient care plays a key role, enabling hospitals to admit screened patients to the correct ward without delay. This not only ensures that they receive the most appropriate treatment promptly, but also helps to avoid breaches of the four-hour accident and emergency (A&E) department target, improving the patient flow through the hospital.

View from the south coast

Torbay Hospital is the main hospital in South Devon and is managed by the Torbay and South Devon NHS Foundation Trust. Its orthopaedic department includes a 26-bed trauma ward and a 19-bed elective surgery ward. All elective beds are ring-fenced, meaning that patients are only admitted following a negative MRSA screen, to minimise the risk and potentially devastating consequences of infection following surgery. Typically, MRSA screening is performed in the laboratory using a culture-based technique, with turnaround times of up to 48 hours. However, with on-demand molecular testing already in use in the laboratory for other disease states, and successfully implemented for influenza and respiratory syncytial virus (RSV) testing in A&E, the orthopaedic and microbiology departments collaborated to introduce fast point-of-care testing (POCT) for MRSA on patients admitted via the emergency department, or on the trauma ward. This has reduced turnaround times to an hour, allowing the safe use of elective orthopaedic beds for appropriate trauma patients, helping to avoid breaches of the ring-fence and subsequent cancellation of planned surgeries.