MRSA colonization and staff - page 2
Not to long ago my old unit admitted a staff member for an emergency medical condition. That hospital did MRSA screening on all new admits and she turned up positive. She was placed in the... Read More
Feb 6, '09If you read the studies where they did decolonization of MRSA, a high percentage were recolonized within 3 months. If you routinely swabbled every hospital emplyee, you'd have to do it constantly. Then you'd have to treat them every time. It has been shown that then MRSA becomes quickly resistant to the treatment. Between testing, treating, and not allowing people to work, you'd just have a huge mess on your hands. It has NOT been proven that poeple with nasal colonization are spreading the MRSA.
Feb 6, '09Quote from oramarNope. They were off for two weeks, paid. I do know of one woman who was actually infected while working, and the strain was identified as originating with a particular patient. She had multiple abcesses that had to be I&E'ed, and it took her a really long time to clear. Our ID people told her if she didn't clear she wouldn't be able to come back to work and probably wouldn't be able to work anywhere, ever again.Interesting, how did the handle the positives? Did they allow them to continue to work while being treated?
Feb 6, '09I just spoke about my state legislative proposal for MRSA prevention in Maine at an AARP meeting. One woman said her daughter has MRSA and she had to quit nursing because of it. It is not unheard of. Care givers are at a huge risk of infection. It only makes me want to get this legislation passed even more...to know good mandates make for a safer work environment for nurses and a safer healthcare facility for patients.
Feb 10, '09I currently work in LTC. Family members will insist on an ATB and put pressure on the nurses to call the Dr. We have one male patient who is colonized with Proteus. He is always asymptomatic and it is difficult to get him to drink enough fluid. His wife visits daily and stares at his foley all day and wants an ATB every time she sees mucous in the tube or thinks it smells when the CNAs empty the bag. I have told this woman a million times, "everybody's pee stinks, Proteus is part of the normal body flora, if you gather your own pee in a container and leave it sit for a few hours you will see things in it, if you keep using ATBs every 30 days you'll grow a supercootie." No one listens to me. Even the CNAs will come to the nurses and say "So and so has a UTI, his urine really stinks". or " So an so is confused, He's got a UTI". I have seen the doctor use IV gentamicin and IV Zosyn on the same residents as often as every 60 days because of this. The same doctor will even fax notes saying "Stop asking me, I'm not treating if he is asymtomatic and we can not clear this up". I think he just gets tired of it and throws his hands up.
Feb 10, '09Prudent use of antibiotics is an integral part of a good MRSA prevention policy. I have it in my Maine Proposal.
Unnecessary antibiotic treatment just because the patient or family wants it has to stop or we won't have any medicines left that will work on anything. Staph and other microorganisms have morphed into "superbugs" because of over use and unncessary use of antibiotics.
I don't work at the bedside anymore. So, I don't pretend to know all about all LTC or acute care. Is there some sort of deodorizer liquid or tablet you can use in the vessel you dump the urine bag into? Also, how often do you change the tubing? These things just come to mind as a possible solutions to the "doctor" wife of that patient. Maybe if the pee smelled like a nice perfume, she would settle down.
If a patients urine doesn't culture positive for anything active, then antibiotics are not necessary. If antibiotics are given repeatedly when unnecessary, you (or the doctor) are setting your patient up for a drug resistant organism that could kill him.
Jun 28, '09I work in chronic dialysis and when I see a significant increase in cvc infections related to mrsa or staph then I recommend we culture the staff nares It usually occurs when we have new staff come in. Last time we found 2 of our staff out of 8 had were active carriers including the secretary. A few weeks of bactroban in the nares and they cleared up and the cvc infections subsided. Even with the use of mask it still spread It could have just be conincidence but I dont like taking chances. It's a simple test and no uncomfortable nor invasive.