Mrsa

  1. 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
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  2. 20 Comments

  3. by   SuesquatchRN
    We made sure everyone who provided care knew and that gloves were worn - which they should be, anyway.
  4. by   jmgrn65
    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.
  5. by   Nascar nurse
    Quote from jmgrn65
    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.
    Same thing for us. We get a written statement from MD verifying that infection is colonized for the chart. We would do our best to cohort roommate with someone else with a colonized infection if at all possible - we tend to get "bed locked" at times and not always possible. Also we try real hard not to be culturing those dang nares - cuz we don't want to know! :spin:

    For the hospital nurses that pick up on this thread.. please don't freak out on us. I realize things get done much differently and often more aggressive in the hospitals as far as infection control, but like the other poster suggested, if we cultured everyone's nares in a LTC facility, we wouldn't have any patients and we definately wouldn't have staff. SYMPTOMATIC infections are a whole different protocol tho.
    Last edit by Nascar nurse on Oct 26, '07
  6. by   CapeCodMermaid
    Thanks for all your replies. I've only been at this particular facility for a few months and have yet to see a comprehensive infection control policy in writing. I called one of the other DNSs at a sister facility and she said it was company policy to keep the person in a private room. I called the corporate clinical nurse and she said there is no written policy. Hmmmm with all the MRSA around here, don't you think it would be a good idea to have policies in writing?? Cape Cod hospital cultures the nares or almost everyone and does rectal cultures of anyone going to surgery.
  7. by   marjoriemac
    We have only single rooms, but all clinical staff advised of mrsa status and wear gloves/ aprons etc. No need for isolation in care home.
  8. by   decartes
    Bactroban in the nares...as per the MD's it is very effective against MRSA. Contact precautions...prevent the spread or MRSA w/in your facility. Private room or assign w/ another w/ same Dx...isolate to protect other clients.
  9. by   txspadequeenRN
    bactroban???????

    Quote from decartes
    bactroban in the nares...as per the md's it is very effective against mrsa. contact precautions...prevent the spread or mrsa w/in your facility. private room or assign w/ another w/ same dx...isolate to protect other clients.
  10. by   decartes
    It's an anti-bacterial ointment.
  11. by   CoffeeRTC
    We are also room locked and it is very, very difficult to move res. That is why we love it when they take these new res with MRSA, VRE, Hep, Cdiff,Shingles all active and try to room them with a res with tubes etc or who might be compromised.

    In the nares..we've used bactroban for 10-14 days then reculture. If colonized, they are not "isolated". We use standard precautions on everyone.

    I'd love to see the actual policies we have too. Seems like they are alway changing.

    Nascar....thanks for posting that warning. When I talk to my mother (works acute care) she is freaked out when I tell her the amt of people we have with infections...most came from the hospital or home before coming into the ltc.
  12. by   Mammy1111
    Colonized MRSA in the nares can be spread to other patients and to other parts of the colonized patient's body. They should be isolated or cohorted. Read your CDC and SHEA recommendations. I am working on mandates in the State of Maine and there is action being taken on the national and world wide level as well for mandated policies to prevent MRSA. There is way to much MRSA "gossip" and not enough fact and guidance for nurses, doctors and other healthcare providers. Dont always believe what your ID doctors say....I have met some who won't even wear a mask while seeing a TB patients.
  13. by   achot chavi
    Quote from CapeCodMermaid
    Thanks for all your replies. I've only been at this particular facility for a few months and have yet to see a comprehensive infection control policy in writing. I called one of the other DNSs at a sister facility and she said it was company policy to keep the person in a private room. I called the corporate clinical nurse and she said there is no written policy. Hmmmm with all the MRSA around here, don't you think it would be a good idea to have policies in writing?? Cape Cod hospital cultures the nares or almost everyone and does rectal cultures of anyone going to surgery.
    Here's ur opportunity to write the policy. In my facility all MRSA's are put together or alone , simply because the families would freak out if they find out that they were mixed- despite the statistics and low risk or no risk of contamination. While we obviously wouldn't advertise the info- families talk and eavesdrop and we wouldn't want to be seen as hiding stuff.
    Good Luck- if u need help- just scream
  14. by   Mammy1111
    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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