Risk management is the basis for preventing and reducing harm arising from a healthcare-associated infection such as multi-drug resistant organisms (MRO/MDROs). 

Strict adherence to standard precautions, with additional transmission-based precautions where necessary, is recommended for residents infected with MRO/MDROs.

Prevention and management involve a combination of interventions rather than one single intervention.

Interventions include

Adequate resourcing with a dedicated infection control professional

Targeting management strategies to high-risk groups

Ensuring and monitoring adherence to strict infection control precautions and practices at all times

Increasing compliance with hand hygiene practices

If an MRO/MDRO is identified in a sputum specimen, masks are required to be worn, and a single room may be recommended

Defining decolonisation procedures when required

Developing response protocols for the management of MRO/MDRO outbreaks

Implementing appropriate environmental cleaning and risk management strategies

Defining environmental controls, e.g., cleaning of resident equipment

Developing and evaluating communication and education strategies for residents, relatives and employees

Developing and maintaining infection surveillance to identify breaches of infection control and provide feedback on results to healthcare workers

Following the completion of a risk assessment, a care plan for affected resident(s) should be developed, implemented, and communicated to all employees to ensure compliance. 

A process should be in place so that healthcare workers can identify residents with infection control risks and associated care plans.

Contact details of an infectious diseases physician, microbiologist, or infection control consultant should be available for further advice on managing residents with MRO/MDROs.