MRSA help!

  1. Hi there everyone! I'm not a nurse (yet. I'm taking prereqs right now) but learned a bit about MRSA when I trained as an EMT. Yesterday, I started a job working at a group home, and I was reading his medical history and saw that he has "inactive mrsa". This was written only on one page out of about 100, which I thought was strange. Shouldn't this be on every single Facesheet and other documentation as well? When I asked my supervisor if he did have it, he responded that the institution he came from made all sorts of mistakes on their paperwork, and that he doesn't have it since he's without signs. Now, from my understanding, if you get mrsa once, you have it forever, right? And it's highly contagious? I feel like nobody knows what is going on where I work, and no one has told me about any risks. Is there a risk of contracting it even if it is inactive? The pt had a recent bout with 'acne', which from what I was reading could've been mrsa related ?? Should I push this and try to find out if he ever had it? Is my health at risk? Thanks for any advice you can give!
    •  
  2. 17 Comments

  3. by   augigi
    Your health should not be at risk if you treat every patient with universal precautions. Many people (likely including you!) are colonized with MRSA, meaning that it's present in their nose/axilla/throat/groin, yet they are not compromised and are not "infected" with MRSA. If it says "inactive", then it probably means it.
  4. by   jmgrn65
    the op is right if it is inactive then it probably is, MRSA can be treated effectively with vancomycin and then it should be gone. Contrary to popular belief it can be treated effectively.
  5. by   CHATSDALE
    be very vigilant as mentioned above with universal precautions.

    you cannot avoid infectous people, this may be colonized but you will have to care for pts with active infections take care of yourself so that you can be there to take care of pts down the road
  6. by   Daytonite
    hi, mollysdirtysprocket!

    here are some links to information about mrsa. it's actually a staphlococcus infection.

    http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html - information for the public about mrsa from the cdc

    http://www.nlm.nih.gov/medlineplus/s...nfections.html - a page of links to more specific information about mrsa conditions on the medline plus site

    http://www.symptoms101.com/med/archi...05/05/msra.php - symptoms of mrsa

    http://mrsa-survivors.org/index.html - mrsa survivor's network. site includes symptoms and a fact sheet.

    http://www.emedicine.com/med/topic2166.htm - staphylococcal infections. from emedicine. includes listing of antibiotics used to treat as well as complications of the infection itself.

    http://www.nlm.nih.gov/cgi/medlinepl...lthcarefs.html - information about mrsa for healthcare personnel. from the cdc.

    join the other pre-nursing students at:
    http://allnurses.com/forums/f198/ - the pre-nursing student forum, or
    http://allnurses.com/forums/f265/ - the cna - nursing assistant discussions forum

    welcome to allnurses!
  7. by   mollysdirtysprocket
    Thanks for all of your helpful replies! About taking universal precautions-- no one working there does. I mean, we all wash our hands regularly, but nothing really beyond that. Since this was only on one page of his records, and the main staff person doesn't think he really has it, is there a test that can be done to find out?

    Thanks so much!
  8. by   Todd SPN
    Daytonite,
    Thanks for the links. I will check them out after work. To the OP, we are seeing many more cases of MRSA at our facility. The problem I see is that it may be colonized, but it can and does become active again. How do you know when it becomes active? We have one res that is classified with colonized that gets UTIs a few times a year and the labs always show MRSA. Had another recently with respitory MRSA. Our infection control nurse said there was no need to gown up unless res was coughing and might get on our uniforms. We of course wear a mask. But what do you do with items she has touched like dinner trays and eating utensils? It seems that we are treating MRSA much more casually than when I had clinicals at the hospital. I have also seen where MRSA is mentioned on one page in a hundred. It does not give you a feeling of security. We have one nurse who can no longer work for us collecting L&I because of contacting MRSA at the facility. Two months ago an aide went to her doctor to have a wound looked at before her wedding and the culture came back MRSA. Your facility has a infection control nurse. I suggest you start asking questions there.
    Todd
  9. by   augigi
    Quote from mollysdirtysprocket
    About taking universal precautions-- no one working there does. I mean, we all wash our hands regularly, but nothing really beyond that.
    Does he have signs of infection? If so, culture the site and see what you grow. If not, he doesn't have an active infection.

    I'd be more worried if "noone" uses universal precautions!! You need to talk to your manager immediately if people are not using GLOVES and gowns as necessary, not to mention masks/goggles when required. There is NO excuse for that. Ever. And if you are as worried about your own health as you seem, I'd be running in the other direction from any facility which does not enforce this policy.

    Are you really saying the staff don't wear gloves or gowns?
  10. by   solumedrol
    Thanks for the links DaytoNite!
  11. by   vampiregirl
    Quote from augigi

    I'd be more worried if "noone" uses universal precautions!! You need to talk to your manager immediately if people are not using GLOVES and gowns as necessary, not to mention masks/goggles when required. There is NO excuse for that. Ever. And if you are as worried about your own health as you seem, I'd be running in the other direction from any facility which does not enforce this policy.

    Are you really saying the staff don't wear gloves or gowns?
    From reading the OP's post, it refers to working in a group home. Many group homes, such as those for individuals with mental retardation or mental illness, unfortunately are fairly lax in universal precautions. The goal of most group homes is to create a "homelike" environment. Typically, individuals with any active contangious illness cannot reside in them, but this is up to the medical director of the facility. Gloves were required to be used regularly when I worked at a group home, when any the possibility of contacting body fluids existed, including assisting with hygeine tasks and laundry. Gowns and goggles should be readily available in the home, for use in such instances as an injury with spurting blood etc. But rarely in the group home environment are gowns and goggles used on a regular basis. I would suggest the OP addressing the concerns to the group home's nurse if the supervisor did not give you a satisfactory answer. The nurse should know the MRSA status of this resident, MRSA is a huge concern in group homes. Also, the nurse may not be aware that universal precautions are not being consistently implemented. Hopefully, the nurse will address that promptly and provide training.

    Group homes can be fantastic places to work if you can find a well-run one. If this particular group home doesn't promptly address the universal precautions issues and the MRSA concern, check around your area if you like working in a group home. Maybe there is another company that also provides group home services.
  12. by   mollysdirtysprocket
    One last question: is there any consensus if it is still contagious in the "inactive" state?

    Thanks for your help guys. You've solidified my instinct that this isn't something that should just be overlooked-- I'm talking with my sup on Thursday and getting contact info for the staff nurse. Thanks!
  13. by   augigi
    The answer is it doesn't matter if it's contagious, since unless you are immunocompromised, open cut (NO GLOVES!) etc, then you won't have a problem. It's not "contagious" ie illness causing unless the recipient is susceptible. You could get MRSA from the hands of a store clerk, but it won't usually hurt you.

    Emtrachel, I'm aware of the need for "homelike" environment, but if I'm working with people's bodily fluids, I'm wearing gloves as a minimum!!
  14. by   AfloydRN
    At our hospital we do not isolate for MRSA anymore. We do not screen for it either.

close