You are working in an ambulatory care clinic in an underserved community and are interested in improving the quality of healthcare that is provided in your area. You are concerned about an increase in the incidence of methicillin-resistant Staphylococcus aureus (MRSA) in the population that you serve. Before you launch an educational campaign aimed at both your staff and the community, you need to establish the severity of the problem.

• Identify a database at the local, state, or national level that can help you obtain the necessary information. − How can you determine the incidence and prevalence of MRSA in your community? − What are some of the potential errors that can occur in the reporting of MRSA to a local, state, or national database? − How might this affect your interpretation of the data? − What are some of the barriers to reporting in your community (i.e., hospital, outpatient clinic, nursing home)? • You decide to begin collecting data on MRSA-related deaths for your local hospital. − What are some of the problems that may occur during data collection? − How might you avoid these problems? • You determine from your investigation that there is a significant problem in your community. − Describe how you would address the increasing morbidity and mortality of MRSA in the population that you serve. − What type of study design would you use to evaluate the effectiveness of your intervention? − What are potential confounders? − Is there potential for interaction?

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