Coming Soon to a Hospital Near You: A Case-Based Approach to the Management of Community-Associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA) Infections in Hospitalized Patients

Jointly sponsored by the University of Wisconsin School of Medicine and Public Health and CME Enterprise

In cooperation with Healthcare Performance Consulting, Inc.

Release Date: February 15, 2011
Expiration Date: February 14, 2012

Supported by an educational grant from Pfizer Inc. and Astellas Pharma Global Development, Inc.

Faculty

Christopher J. Crnich, MD, MS
Assistant Professor of Medicine,
Division of Infectious Diseases
University of Wisconsin School of Medicine and Public Health
Physician and Hospital Epidemiologist,
Wm. S. Middleton Veterans Administration Hospital
Madison, Wisconsin

Educational Reviewer

Andrew Urban, MD
Associate Professor of Medicine,
Division of Infectious Diseases
University of Wisconsin School of Medicine and Public Health
Madison, Wisconsin

Planners

Danielle Hepting
University of Wisconsin School of Medicine and Public Health
Madison, Wisconsin

Chris Larrison
Healthcare Performance Consulting, Inc.
Carmel, Indiana

Tom McKeithen, Jr, MBA
Healthcare Performance Consulting, Inc.
Fleming Island, Florida

Amy Robertson
CME Enterprise
Carmel, Indiana

Sheila Robertson, MPH, CCMEP
CME Enterprise
Carmel, Indiana

Activity Details

Target Audience and Scope of Practice

This intervention is specifically designed for an interdisciplinary group of healthcare professionals who participate in the care of patients with infectious diseases in the hospital, including emergency medicine physicians, hospitalists, hospital staff physicians, and infectious disease specialists.

Overview

The Antimicrobial Resistance Education Alliance (AREA) is a multiyear educational initiative comprising many components designed to address clinician and system performance gaps that contribute to antimicrobial resistance.

This component, an interactive case-based activity, walks learners through an unfolding clinical scenario with several decision-making points around the management of a patient presenting with or at risk for various infectious disease diagnoses. In particular, this activity addresses ways in which CA-MRSA has now emerged as a nosocomial pathogen, causing serious infections in hospitalized patients, and demonstrates the practical application of current knowledge in the care of these patients.

Elements of Competency

The overall goals of this activity range from improved knowledge to assisting performance change in practice.

The competencies set forth by the American Board of Medical Specialties (ABMS) and the Accreditation Council for Graduate Medical Education (ACGME) provide the framework required to address physician needs through this activity as identified below.

Need	ABMS/ACGME Competencies
Improve physician ability to stop antimicrobial treatment when cultures are negative and infection is unlikely.	Patient Care Medical Knowledge Practice-Based Learning and Improvement
Improve/refine physician skills in utilizing anti-MRSA antimicrobial agents appropriately.	Patient Care Medical Knowledge Practice-Based Learning and Improvement
Improve physician skills in targeting empiric therapy to likely pathogens and local antibiogram.	Patient Care Medical Knowledge Practice-Based Learning and Improvement
Improve physician performance around culturing the patient.	Patient Care Practice-Based Learning and Improvement
Improve physician performance to stop antimicrobial treatment when infection is cured.	Patient Care Medical Knowledge Practice-Based Learning and Improvement

Learning Objectives

Upon completion of this activity, learners should be able to:

1. Diagnose MRSA infections using epidemiologic risk factors, molecular biological typing methods, and the results of culture and susceptibility testing.
2. Describe the classification of CA-MRSA and HA-MRSA, and distinguish between community-associated and hospital-associated MRSA infections.
3. Utilize appropriate empiric antimicrobial therapy in accordance with accepted guidelines when the risk of MRSA is sufficiently high.
4. De-escalate antibiotics once results of cultures and the patient’s clinical response are available.
5. Delineate the place for each anti-MRSA agent in therapy based on current guidelines and recommendations.

Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the University of Wisconsin School of Medicine and Public Heath and CME Enterprise. The University of Wisconsin School of Medicine and Public Health is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

The University of Wisconsin School of Medicine and Public Health designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Faculty Disclosure Statement

It is the policy of the University of Wisconsin School of Medicine and Public Health that the faculty, authors, planners, and other persons who may influence content of this CME activity disclose all relevant financial relationships with commercial interests* in order to allow CME staff to identify and resolve any potential conflicts of interest. Faculty must also disclose any planned discussions of unlabeled/unapproved uses of drugs or devices during the educational activity. For this educational activity, all conflicts of interests have been resolved and detailed disclosures are listed below:

Christopher J. Crnich, University of Wisconsin School of Medicine and Public Health
Dr. Crnich has no relevant relationships to disclose in regard to this activity.

Danielle Hepting, University of Wisconsin School of Medicine and Public Health
Ms. Hepting has no relevant relationships to disclose in regard to this activity.

Chris Larrison, Healthcare Performance Consulting, Inc.
Mr. Larrison has no relevant relationships to disclose in regard to this activity.

Tom McKeithen, Jr, Healthcare Performance Consulting, Inc.
Mr. McKeithen has no relevant relationships to disclose in regard to this activity.

Amy Robertson, CME Enterprise
Ms. Robertson has no relevant relationships to disclose in regard to this activity.

Sheila Robertson, CME Enterprise
Ms. Robertson has no relevant relationships to disclose in regard to this activity.

Andrew Urban, University of Wisconsin School of Medicine and Public Health
Dr. Urban has no relevant relationships to disclose in regard to this activity.

*The ACCME defines a commercial interest as any entity producing, marketing, reselling, or distributing healthcare goods or services consumed by, or used on, patients. The ACCME does not consider providers of clinical service directly to patients to be commercial interests.

NOTICE: The University of Wisconsin School of Medicine and Public Health advises the participant that this continuing medical education activity contains reference(s) to unlabeled or unapproved uses of drugs or devices.

Disclaimer

The views and opinions expressed in this activity are those of the faculty and do not necessarily reflect the views of the University of Wisconsin School of Medicine and Public Health, CME Enterprise, Healthcare Performance Consulting, Inc., or recommendations of the commercial supporter.

How Do I Receive My Credit?

After participating in this activity, you will be redirected to the University of Wisconsin School of Medicine and Public Health’s Office of Continuing Professional Development Web site to complete the activity posttest and evaluation and receive a credit letter online. This activity is available to complete at your convenience 24 hours a day, seven days a week through February 14, 2012. Credit will not be given after this date.

For questions regarding the content of this activity, contact the accredited provider for this CME activity, the University of Wisconsin School of Medicine and Public Health, by e-mailing Danielle Hepting at drhepting@ocpd.wisc.edu.

Method of Participation

This activity should take approximately 60 minutes to complete. Approximately 50 minutes should be spent participating in the activity. The remaining 10 minutes should be used to complete the activity posttest and evaluation. As part of this activity, you will receive a follow-up e-mail in 6-12 weeks to remind you of the content and inquire about its application in your practice. There are no fees or prerequisites for participants.

Computer Requirements

Participants will need the free, current version of Internet Explorer or Firefox. (Some older browsers could produce error messages or not display the content correctly.) Participants will also need to download the free, current version of

Adobe Reader and Adobe Flash.

Help

For technical assistance, e-mail Katie Fanning at katie_fanning@cmeenterprise.com.