MRSA Please Help

[nursex20]

I need everything you know about MRSA.

I was called this week by a coworker and friend who has been sick lately and just learned she is MRSA positive ( a carrier).

She and I worked together on a case that I was on for over a year.

She called as a friend thinking that I might want to know that she tested positive (I did).

She called as a nurse who had lost the rest of her team to ask if I remembered when the diagnosis was made because she heard it from the mom but it was nowhere on the home chart or POC.

She is still on the case and I am with a new baby.

I replied that MRSA was never diagnosed in the time I worked there and it was never on a POC prior to her starting the case. We would certainly have told her.

I called the agency DON and asked why we did not have Lab work included in our home charts and what we were supposed to do to protect ourselves without correct information or protective gear.

I have heard from up my chain of command so far that

"90% of all nurses have colonized MRSA in their noses".

"40 percent of the population are carriers of MRSA, no big deal"

"We are in HIPPA violation for discussing this and should have let the agency handle it by calling us". The original nurse did report to her case manager (whose job it is to keep POC updated).

The DON of agency is saying that just gloves and handwashing are sufficient precaution for trach. colonized MRSA but she has a call in to the CDC to see what is required.

So, from that one phone call I am hearing that in the days since they have known about the first nurse testing positive the primary concern of the agency is to contact CDC and see what they are liable for.

????????

Thanks for the call to warn me and all the other nurses that we might want to get tested.

I have never NOT felt safe in home health simply because I have always known my babies and their histories and work on average of 1-2 years with each case. This really sux though. I am more angry I think that the agency doesn't care more about us in the field. The DON actually asked me if I could afford the HIPPA fine for talking to my co-worker about this since I was no longer on that particular case.

My Doctor fit me in at 9 this morning and ordered chest x-ray, CBC, UA with culture and did a throat culture. I just finished all that and now am worried because the other nurse had her nares cultured but he did my throat. I am getting such mixed information and being made to feel like a bad nurse for being worried about my own health.

The other nurse is on isolation with Hibiclens showers X5days, Doxy, Bactroban swabs to the nares X5 weeks. After the 5 day isolation and Doxy she may return to the outside world and continue meds until reswabbing in 5 weeks or so. Her doctor is certainly not taking it lightly and doesn't think it's ok for her to just be a "carrier".

What experience does anybody have in Hospital and other settings with dealing with MRSA?

I think we are getting swept under the rug here because the agency in question is

a) worried about their own OSHA violations and

b) getting flack from the mom involved because nurses have refused to go back out on the case without masks, gowns and OSHA compliant protective gear as well as family compliance with isolation techniques when baby has

[barefootlady, ADN, RN]

Worked with a nurse who was infected by "unknown" source. She was given a triple lumen IV and was on Vanco q day x 2 weeks. Bactroban nasal swipes. Could not work but had to fight for comp. I hope things turn out o.k. for you. You are in my prayers.

[nursex20]

I really appreciate your help and prayers.

I am not finding much at all in the way of Regs. for mrsa in the home health setting so I am assuming that one would be smart to follow the CDC guidelines as closely as possible and it is not looking good for what I have been exposed to for a year with no idea to mask .

The nasal colonization I can see as a hazard of nursing anywhere and very treatable but to have dealt that long with a colonization in the trach of a baby I held in my lap to do CPT on....

Well, I often got as much neb. tx exhaled from her as she did as well as the coughing when I suctioned her, especially after the vent was weaned and she was trach only.

I am furious with the agency and their attitude with this.

We'll see what happens and I will have to go Monday and have nares swabbed since my doc mistakenly did throat culture.

Wish me luck!

[renerian, BSN, RN]

I do not remember the title but there is only one book that covers home health for infection control since home health is a weird animal. When I write P&P I go to the CDC for current practice standards as a marker.

renerian

[Terri Rearick]

Methicillin Resistant Staphylococcus aureus (MRSA) is indeed present in hospitals; however, if you search community-acquired MRSA you will find that the prevalence is ever-increasing. You can also call the CDC and ask to speak to a qualified expert on such topics.

I need everything you know about MRSA.

I was called this week by a coworker and friend who has been sick lately and just learned she is MRSA positive ( a carrier).

She and I worked together on a case that I was on for over a year.

She called as a friend thinking that I might want to know that she tested positive (I did).

She called as a nurse who had lost the rest of her team to ask if I remembered when the diagnosis was made because she heard it from the mom but it was nowhere on the home chart or POC.

She is still on the case and I am with a new baby.

I replied that MRSA was never diagnosed in the time I worked there and it was never on a POC prior to her starting the case. We would certainly have told her.

I called the agency DON and asked why we did not have Lab work included in our home charts and what we were supposed to do to protect ourselves without correct information or protective gear.

I have heard from up my chain of command so far that

"90% of all nurses have colonized MRSA in their noses".

"40 percent of the population are carriers of MRSA, no big deal"

"We are in HIPPA violation for discussing this and should have let the agency handle it by calling us". The original nurse did report to her case manager (whose job it is to keep POC updated).

The DON of agency is saying that just gloves and handwashing are sufficient precaution for trach. colonized MRSA but she has a call in to the CDC to see what is required.

So, from that one phone call I am hearing that in the days since they have known about the first nurse testing positive the primary concern of the agency is to contact CDC and see what they are liable for.

????????

Thanks for the call to warn me and all the other nurses that we might want to get tested.

I have never NOT felt safe in home health simply because I have always known my babies and their histories and work on average of 1-2 years with each case. This really sux though. I am more angry I think that the agency doesn't care more about us in the field. The DON actually asked me if I could afford the HIPPA fine for talking to my co-worker about this since I was no longer on that particular case.

My Doctor fit me in at 9 this morning and ordered chest x-ray, CBC, UA with culture and did a throat culture. I just finished all that and now am worried because the other nurse had her nares cultured but he did my throat. I am getting such mixed information and being made to feel like a bad nurse for being worried about my own health.

The other nurse is on isolation with Hibiclens showers X5days, Doxy, Bactroban swabs to the nares X5 weeks. After the 5 day isolation and Doxy she may return to the outside world and continue meds until reswabbing in 5 weeks or so. Her doctor is certainly not taking it lightly and doesn't think it's ok for her to just be a "carrier".

What experience does anybody have in Hospital and other settings with dealing with MRSA?

I think we are getting swept under the rug here because the agency in question is

a) worried about their own OSHA violations and

b) getting flack from the mom involved because nurses have refused to go back out on the case without masks, gowns and OSHA compliant protective gear as well as family compliance with isolation techniques when baby has

[renerian, BSN, RN]

Recent story on NPR on this topic. Check out the CDC and sift through their listing.

renerian