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 isolation as per infection control recommendations. Fine, problem is that 24 hours before the woman was taking care of patients. This brings the question to mind as to why all staff are not screened routinely? I really think it is time for hospitals to face up to the fact that they are squirming out of doing a screening proceedure on staff that actually makes sense. Why do Tb test and hepatitis screens on new hires and yearly on exsisting staff and not do MRSA swabs? What reasons do they have for not doing it? I think they are running out of excuses on this one. Every time I have asked infection control people and managment people about it I have heard a lot of mumblings and no real answers.
I hate that we are slowly going back to over culturing. I honestly believe misuse of antibiotics got us where we are today with MRSA & VRE. I work with geriactric residents. The biggest thing I see is we study the effects of meds on peds and adults, but not enough on the elderly. Therefore our Dr's treat our geriactric residents as if they were 40 yrs old. I am finally beginning to see progress being made in this area. Our guidelines are getting tougher in LTC. Many nurses get agrivated with the new changes, but if you really research and read, these are mostly good changes. Finally I am seeing emphasis being put on duplicative therapy, unnecessary medication, polypharmacy. And there is going to be more emphasis on infection control in LTC in state surveys. This makes our jobs harder, but if you look at how our infection rates are rising, you will understand why changes must be made. I still see our medical staff treating colonized infections, and nurses getting phone orders for antibiotics d/t residents showing signs of confusion. These new regs are making us take a step back and think outside of the box. There are other things that can cause confusion in the elderly other than a UTI. Try polypharmacy for one. I will be the first to admit the changes make more work on us poor nurses, but I am sure you all will agree, if you are a LTC nurse, you do it because you love your residents. The one thing everyone should learn about treating infections is the CDC criteria for infections. There has to be signs and symptoms of infection present to classify it as a "true infection." Asymptomatic cultures are a waste of time and money. In my experience, a nurse can culture a geriactric residents urine and it almost always grows out something. Unfortunately, they are almost always treated with an antibiotic because all the MD saw was the C&S. He didn't know that the nurse obtained the culture because the resident had a foul urine odor. This is only one symptom, according to the CDC, it is not a true UTI if you only have one symtom. I wish our nurses could grasp that foul urine odor is also an indicator of dehydration. I have tried to educate my staff about these guidelines. Sadly it is the nurses that have 15 yrs experience with RN degrees that feel like CDC guidelines is not what they should go by. They want to use the "in my experience" card and treat everything with an antibiotic. Sorry to get on a soap box, but I have a hard time getting infection control across to my staff d/t the person that put me in this position loves to write the antibiotic orders. (MY DON) Unfortunately, she is the boss and I will not give up trying to educate her about infection control. I just have to do it very carefully.
Last edit by angelaQAICnurse on Jan 5, '08
: Reason: addendum
Im glad there is already a thread aboust colonization of MRSA in nares of healthcare workers. I would like to know if anyone can enlighten me, or am I just being paranoid and uninformed? My grandaughter has had numerous ear and sinus infections, almost one a month especially now in winter. I dont think they ever cultured her, so I dont know what she has been infected with. I am So paranoid that I may be MRSA colonized and infecting my poor little grandaughter, is this possible? I havent worked for almost two years, but did work for almost 29 years in LTC.Is it possible to infect people we are in close contact with? I try not to give her kisses on her lips, but only her cheek.
Last edit by Simplepleasures on Jan 9, '08
I'm a new member ,just joind yesterday I'from kingdom of Bahrain , I was atracted to read this subject, but it add so much for me, I thought we are the onley one who is suffering with resistant organism and peaple, but we were all same,
In my country we will secreen the staff once needed in case of out break , but its not the first measure, as we know that MRSA is communicable, not hospital acquired infection, so its normally to have any staff with MRSA, but being in hospital daily will increase the risk of being colonized of course.
Now adays we have high rate of esbls, which is another big story....
What to do? This is our life fighting organism here and there...
Last edit by BBFRN on Aug 14, '08
: Reason: Changed All Caps