Mrsa

Specialties Geriatric

Published

What do you all do for MRSA in the nares? If the patient has no symptoms do you put them in a private room? I don't see the need for a private room if the MRSA is only in the nares

Specializes in ER, Urgent care, industrial, phone triag.

Your facility is avoiding the issue by avoiding a written policy on MRSA. Hospital and nursing home administrations can only hide their heads in the sand for so long about MRSA. Someday, somehow, somebody will sue or have a class action suit against facilities and they will win It's to bad to bring it all down to litigation, but getting facilities to pay for thier lackadaisical attitudes about HA infections is what will make them smarten up.

The other way to get them to have a policy is to write a legislative proposal for your state or support somebody who is doing that. Hospitals have to observe mandates or risk losing their accreditation or funding. Again, it comes down to money with these places. Too bad it doesn't come down to providing safe and excellent care for the clients of these facilities.

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Specializes in Gerontology, Med surg, Home Health.

Since this was an old post......

Luckily I have moved to a different facility owned by a corporation that really has not a clue about skilled nursing so I can do what I want and write whatever policy I want! It's great.

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Specializes in acute care and geriatric.
Since this was an old post......

Luckily I have moved to a different facility owned by a corporation that really has not a clue about skilled nursing so I can do what I want and write whatever policy I want! It's great.

Good For You- I always say the best way to deal with weak facilities is to vote with your feet. They must have more than a clue about skilled nursing- after all they hired you!!

I had not noticed the date on the original post- sorry for the useless comment.

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Specializes in Gerontology, Med surg, Home Health.

No well intended comment is ever useless.:coollook:

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Specializes in ER, Urgent care, industrial, phone triag.
it is probably colonized, if no s/s of infection then no need for isolation. that is per our ID docs. Most people have it in their nares.

Whoa, are you saying your ID docs do not recommend Isolation and contact precautions for MRSA colonized patients?

I'll just bet you have a pretty good number of infections in your hospital. Colonized patients can spread MRSA just like infected patients can. If they are colonized in their nose, sneezing and coughing can spew it about 4 feet away and MRSA from any colonized area of the body can spread by hand contact of that patient with nurses, or indirectly by using the same facilities as other patients, visitors and nurses.

Also, "most people have it in their nares" is an inaccurate statement...by your ID docs. It is probalby less than 20% of people who have it in their noses, well maybe higher in your facility because of inaccurate information and prevention.

Your ID docs need to read some literature on the latest studies and stats.

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Specializes in LTC.Home Health,.

MRSA in the nares is a common thing if you test a normal healthy person it can come up posative for this. I would say it is colonized and if they are showing no sx. we normally don't treat it. Universal precautions is of course standard in care. I have seen some order bactroban to the nares but we do not isolate for this. To culture for MRSA we culture two sites, such as the nare and a wound.

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Specializes in ER, Urgent care, industrial, phone triag.

A person with MRSA colonization can spread MRSA just as a MRSA infected person can. A healthy individual with colonization who is hospitalized should be isolated from MRSA negative patients. Contact precautions should be used. Also, that patient should be decolonized unless it is contraindicated for some reason. Decolonization is generally a simple procedure and it generally works well. Although the results may be transient, it will help to protect the patient from invasive MRSA after surgery, central line placement or use of a ventilator while hospitalized. A break in the skin because of an invasive procedure (surgery, central lines) is all it takes for the germ to cause serious invasive infections. ET tubes can also introduce MRSA into the lungs.

Colonized patients need to be either isolated or cohorted. Cohorted means rooming with another MRSA colonized patient. Otherwise, the spread of MRSA will continue.

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Specializes in Gerontology, Med surg, Home Health.

We're talking long term care here...not hospital. It isn't as stringent in a SNF....people LIVE there and can not be expected to stay in their rooms.

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Specializes in ER, Urgent care, industrial, phone triag.

I see, I thought we were discussing hospital care. Nursing home patients should still be isolated if they have respiratory MRSA and cannot wear a mask when they leave their room. Coughing ( with sputum and respiratory MRSA) is hard to contain unless there is a mask. Other MRSA such as GU, skin, etc can be contained and with proper and careful handwashing they can avoid spreading the microbe. Same goes for the HCWs.

Yes, there is a difference, but some day there may be somebody addressing MRSA more strictly in LTCs too. It is way to commonplace in Nursing homes.

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