I wonder if some kind soul from this discussion area would drop into the operating room nursing area and tune in to the MRSA discussion? This issue comes up all the time, and, especially in the operating room, I am wondering if what we are told to do is little more than voodoo.
Thanks. Below appears the original question and my own response; there are more. We look forward to your input.
Originally posted by carcha
In our or when we have an MRSA, patient, we clear the room or non essential furniture, have two clean nurses in the or and one to circulate outside. when we finish we recover the patient in the or and then we shower and change while the or is cleaned and the walls are washed down. Is our practice up to date, over the top, rubbish or what. What do u do?
Carcha, I have worked in ORs where they do as you described with MRSA and VRE patients--even one where they had engineering come in and do something weird to the ventilation system, so that the air in the room was exhausted to the outside (literally, OUTDOORS, or so they said) but I don't know that any of that was necessary. or if they were following any infection control guidelines by doing so.
They also made a big point of telling housekeeping, "This patient had MRSA (or VRE)" whether houskeeping did anything different, I don't know. Maybe they cleaned everthing with bleach. I always thought, with universal precautions we treat every case as an infectious case, so why do we have to do anything different with MRSA or VRE?
Also, they used to change the soda lime canisters on the anesthesia machines after any MRSA or VRE patient, and did not use the room for the rest of the day; even after terminal cleaning and even if it caused the schedule to get behind (letting a perfectly good room go to waste.)
Somehow, I think the overkill is similar to what we saw in the early '80s with AIDS patients--people tend to freak out when they are uninformed or underinformed about a disease process--with AIDS, however, we really WERE uninformed, as HIV had not yet been pinpointed as the cause.
One thing I do agree with is recovering these patients in an isolation room in PACU--I figure it can't hurt if one is available--but it may not be at all necessary, as long as universal precautions are followed.
I don't know--I've never seen any written infection control guidelines, at least hospital or unit based ones, that say one way or another if isolation is necessary--I think they are in isolation rooms in ICU (these patients are usually pretty sick, and immunocompromised for other reasons, so I think the rationale for isolation is to protect THEM from the many bugs in an ICU setting--not because of paranoia on the part of the staff surrounding MRSA or VRE.)
I wish an infection control nurse would drop in to this discussion area and give us her thoughts.