I think peri/rectal swabs are a humiliating 'welcome' to the hospital

[FireStarterRN]

On some units we are starting MRSA screening on all new admits. They have to agree to it, of course. We are supposed to do a nasal and a peri-rectal swab. I was on a unit that just started doing this, it was their opening day of this new policy so I had to ask all my patients to allow me to do this screening. A couple of the patients allowed both areas to be swabbed and a couple only would let me do the nasal swab.

The whole peri/rectal swab thing is demeaning, in my opinion. What a way to start out as a patient at a facility! You have to put on a patient gown and proffer your backside to the nurse, after being asked a bunch of embarrassing questions.

This is why I hate the whole healthcare system whenever I am in the patient role, which has been rare. No wonder people feel powerless. There are a lot of things that contribute to the stripping of human dignity in our healthcare system, and this peri-anal swabbing has got to definitely be in the top 10 list.

[Ivanna_Nurse, BSN, RN]

Maybe this has been adressed, and forgive me if so... you use one swab for nares and the other for the rectal area and they go in the same tube. How do you know if they need something for their nares or their rectum?? Can you bactroban their backside??

~Ivanna

[chickie]

The nare swab goes into one culture tube, the groin swab goes into another culture tube and the rectal culture goes into another culture tube. It is treated with antibiotics:specs:

[Okami_CCRN, BSN, RN]

At my facility we stopped doing rectal swabs... not enough evidence we heard

[Daisyclv]

While the peri-rectal swabs may be humiliating they are done for a very good reason. Most likely your hospital has seen a rise in the rates of hospital acquired VRE and MRSA so they want to be able to detect patients who are coming in colonized with these organisms and get them isolated earlier to prevent the spread. While humiliating I know that if I were a patient there I wouldn't mind since it would be protecting me and the other patients around me.

[caroladybelle, BSN, RN]

Well, alot of facilities have to prove a pt came in with an illness, because if it shows up later, insurance will not pay for treatment. That and you do not want to spread it to other pts in semiprivate rooms.

[whitebunny]

our emergency does 3 swabs for VRE and MRSA, one for MRSA nare, two for MRSA and VRE peri/rectum. sometimes emergency ships pts to medicine ASAP so I do 3 swabs for the admission anyway. I explain to pts that in order to proect the pts and the staff of the whole floor, especially that you are in a 4-bed rm with one shared bathroom, it is very important that we do those screening to rule out those commonly spreaded infectious diseases. I emphasize "we do this on everyone." then I tell the pt "in order to make things easier, im taking the nare swab from you right now, and leave the two peri/rectum swab for you to do it yourself. Plz remember to collect the sample during the 1st toilet." This works all the time, and it also does not confuses the nare/peri tubes with each other.

During the admission, they might start developing c-diff or UTI. Then all kinds of lab collections come up, urine (foley or 24-hr), stool (c-diff or FOB). Later on much more such as PICC, CVC, wound, fistula swabs.

IMO, health care provider consider the whole hospital infectious disease status as one of the top priorities, rather than individual's self-esteem or nurse-pt relationship sort of thing. Pts do understand that and I like doing screening. I just went through VRE/MRSA screening before I got hired in July 2012.

[kakamegamama]

Ah, yes...the perianal swab. Been there done that....as a nurse in a foreign country. Now THAT was embarrassing! Especially since we had to line up, drop our pants/raise our skirts, well, you get the picture. But, back to the patient.....I'm with the others about why not just a nasal swab. I would decline the perianal, I do believe.

[kakamegamama]

And, might I add, if health care providers followed isolation procedures and other universal precautions correctly and consistently, MRSA and VRE would be less of a problem, imnsho.

[umcRN, BSN, RN]

I was a patient not too long ago, initially admitted to the ICU but essentially walked in (had driven to the ER that morning) and I told the nurse I was very capable of doing my own swabs haha. Of course when I was readmitted after surgery (after discharge and surgery a week later) I was not with it enough to do the swabs but I sure can remember it being done, ugh!

The hospital I work in has policies that vary by unit. The nicu does VRE/MRSA on all admits (and weekly on everyone) but the CICU does a once a month MRSA swab on whoever happens to be in the unit at that time, they don't do the VER swab at all and I have no idea what they do in the PICU or on the floors.