# Patient Movement and Impact on Multidrug-Resistant Organism (MDRO) Transmission

> **NIH VA I01** · VETERANS HEALTH ADMINISTRATION · 2021 · —

## Abstract

Multidrug-resistant organisms (MDROs) are endemic in both acute care and nursing homes (NHs). However,
predictors for new MDRO acquisition in older adults and transmission to healthcare professionals (HCPs) and
the environment, particularly outside of patient rooms, remain unclear. This is relevant in today’s
contemporary healthcare systems with patient movement outside the rooms for medical diagnostics and
treatment- such as rehabilitation including physical and occupational therapy, procedures such as biopsies,
services such as dialysis, infusion clinics and recreational activities- presenting a tremendous potential for
transmission of organisms
With this project and a focus on high-risk NH Veterans, our aims are to first characterize the changing
epidemiology of MDROs at 3 VA NHs with the explicit goal of developing a ‘Patient Movement Index’ depicting
the role of out-of-room visits for medical appointments and recreation in MDRO transmission across the
institution. Using molecular and genomic methods, we will develop an understanding of the impact of MDRO
transmission, predominant strains circulating in the NHs and other patient use areas. Using an ‘Intervention
Mapping Framework’ we will next develop and pilot an integrated multi-modal intervention involving
Veterans, their families, HCP as well as leadership to reduce transmission and infections. We anticipate this
intervention to include: 1) Veterans’ and caregivers’ hand hygiene and infection prevention education; 2)
provider education on MDRO prevention strategies and environmental cleaning; and 3) leadership
involvement including infection prevention team, VA NH leadership, and managers of common use areas
frequented by our participants. Patterns of patient movements outside their rooms as well as the molecular and
genomic data obtained in Specific Aim 1 will be critical in informing our intervention.
Our proposed translational study is innovative and timely as we plan to develop a new index that will
characterize the amount of time Veterans spend outside their immediate environment in a colonized state and
define a “fingerprint” of Veteran-caregiver-environment contamination. These studies will open a new line of
inquiry allowing us to design future projects in order to characterize patient movement and transmission in
other service areas such as hospitals and specialized units. We expect our results to have widespread
application within and outside the VA, enhance Veterans’ quality of life by improving their hygiene practices
and preventing infections, and help understand MDRO transmission within an evolving healthcare system.
Our multidisciplinary team with expertise in aging, epidemiology including molecular epidemiology,
microbiology, infectious diseases, health outcomes, nursing and patient oriented research is uniquely
positioned to achieve our goals and advance the field.

## Key facts

- **NIH application ID:** 9890591
- **Project number:** 1I01CX001691-01A2
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** Lona Mody
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-04-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9890591

## Citation

> US National Institutes of Health, RePORTER application 9890591, Patient Movement and Impact on Multidrug-Resistant Organism (MDRO) Transmission (1I01CX001691-01A2). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9890591. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*