ID Question

  1. I'm sorry if this has been covered before, I'm out the door and too lazy to search.

    But I was wondering what is your hospital's policy regarding MRSA isolation. Is it contact precautions for any site. Or do you where a mask for sputum.

    Once upon a brief time, we weren't wearing masks in MRSA sputum, but got a new Inf. Control Nurse who changed it to back to wearing masks. I respect her a lot as she has aggressively decreased the ID rate in our facility.

    But I also had a pulmonologist tell me that unless you drink the sputum you can't get MRSA respiratory from a patient's room. Are there little MRSA germs in the air that we can breath in? God help us all is that's true. LOL

    Our infection policy is mainly so we don't bring it from patient to patient. I've yet to hear of a nurse in our facility getting MRSA sputum. (We did have one get a wicked infection in his hand when he got cut by a piece of suction equipment in a MRSA room).

    Anyway, what do you guys do? Mask or no mask.

    Also, we isolate EVERY single nursing home patient that's admitted until we culture their nares, and various other things. Is this more and more common.

    Thanks.
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  2. 23 Comments

  3. by   whipping girl in 07
    We use contact precautions for MRSA and do not use a mask for MRSA in sputum. However, I think that's a good idea. We have masks, eye shields and gowns in every room, so even if a patient is not in isolation or under certain precautions, we do have the equipment available if it's needed.
  4. by   ShandyLynnRN
    Since I work OB, I never see MRSA patients anymore, but where I used to work, we did full gown mask and gloves for sputum. Just gown and gloves for wounds.
  5. by   NurseShell
    The facility I was just at was gown, gloves and mask (for sputum MRSA).
  6. by   RNPD
    Contact precautions (which are indicated for MRSA) indicate glove and gowns if you will touch (or anticipate that you will touch) the patient or any surfaces in the room within 3 feet of the patient. This includes brushing against side rails with your uniform, so it is a good idea to routinely gown & glove in MRSA isolation rooms. Mask is indicated if you anticipate getting splashed. Since I have seen one too many MRSA patients hawk up a big glob of sputum at the most inopportune times, you can bet I wear a mask, especially if they aren't capable either mentally or physically of covering theirs mouths! Actually, I also wear a mask ANY time I suction, documented infection or not. One too many sore thraots convinced me of this!
  7. by   sunnygirl272
    Originally posted by RNPD
    .....Since I have seen one too many MRSA patients hawk up a big glob of sputum at the most inopportune times, you can bet I wear a mask, especially if they aren't capable either mentally or physically of covering theirs mouths! ...
    ack..tell me about the inopportune loogy-hackers!! back in my hospital days, we had a contracted old fellow....in w/ pneumonia...had initially been on AFB, but sputums came back clear...even "deepsuctioned" ones...after he kicked off, he was posted...(who knows why..but lucky they did...) turned out he had TB after all......
  8. by   Rena RN 2003
    gown, glove and mask in our hospital too.
  9. by   altomga
    the hospital I work at has a pathogen pilot program...every pt from a nursing home, every dialysis patient admitted, and every pt from an outside hospital that spent 4 days and on abx's are all put on contact isolation from day one until cultures are clear. (and yes we culture nares, rectum, pegs, trachs and wounds). We use gown and glove. If the mrsa is in the sputum it was just started within the past few months that we have to wear a mask and put the pt on droplet isolation along with contact!
    Almost every pt on my floor is on isolation...the staff look like a bunch of ducks!! (we have yellow gowns!
  10. by   HeartRNJenn
    At our hospital, we are required to wear gown and gloves within 3 feet of the patient and mask if splash...I always wear it all- sputum grosses me out anyway...
  11. by   karenG
    OMG

    well I work in general practice and we dont take any special precautions when dealing with MRSA in wounds!! well, other than the usual keeping everthing clean! and no, we dont spread it around our patients- usually manage to clear it with Inadine dressings. its not a big thing in the community!

    Karen
  12. by   emily_mom
    If it's in a wound, we wear gowns and gloves.

    If it's airborne we wear the above plus mask...splash shields are available too.

    Just had an inservice on MRSA and they said that it is so heavy (in the air), it will only travel 1-2 ft before dropping. Much different than TB...thank goodness our TB isolation rooms have been empty since I started.....:eek
  13. by   karenG
    oh boy I can just see us wearing gowns etc here in the community. is there any evidence to suggest that this is needed in wound care? our experiance is that it is not needed! we see people with infected wounds as part of normal surgery, in our normal consulting room and take just the normal precautions. ie we wear gloves and use a sterile dressing pack! and thats it!!

    Karen
  14. by   sixes
    I worked in home care settings. Anyone that has mrsa or vre our guidline is mask, gloves, gowns. We have yet to transmit to other clients. Also if ambulance is needed, the must be told that client is infected to the bus can be prepared properly. All equipment is left in the home ie b/p cuff stethscope etc. When the client is d/c stuff that can be autoclaved is the rest is disposed of. Any un used product is thrown out therefore we only bring in minimal amounts at a time to prevent needless waste

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