MRSA legislation in Maine

Although my legislative proposal is about MRSA, my hope is that it will open dialog about other HAIs. I have addressed the issue of MRSA in LTC patients in the proposal. A new form will be added to charts of patients who are being transferred to or from a LTC. A green form means the pt is not MRSA positive and a red one means they have MRSA and details the location of the infection or colonization. It is a simple but very meaningful step in helping the receiving facility to be prepared and use the appropriate isolation and precautions.
Hope this idea helps.
My ultimate goal is to come up with an effective and necessary mandate in Maine. But ultimately it is what we need nationwide to fight the plague of MRSA. Maybe our new administration will actually force the CDC to do what we expect them to do, by mandating effective MRSA prevention in the entire country.
Thanks for your support in this.

I agree that edcuation of all care givers (including EMTs) in the area of infection control is essential. Part of my legislative proposal is education, of everybody involved in patient care including all caregivers, patients AND their families and visitors. That would include EMTs. Transparencey and acknowleging the fact that MRSA and other hospital acquired infections is indeed a problem that is NOT going away is a big first step in prevention..
I would recommend to any EMT to demand infection control education regarding safe and clean transfer of infected patients. Effective cleaning after each patient is essential as is appropriate precautions. These steps help to protect EMTs and any patients they transfer after an infected patient.

I think your idea is 100% warranted, and you should do it. I honestly believe the dialog about DROs should be open and honest. All of us caregivers need to be aware of the numbers of infections there are and how to avoid contracting it ourselves and how to protect our patients from contracting it. There has been a culture of secrecy. I believe it is because hospitals and doctors are afraid of liability and accountability when it comes to these horrible infections. WE need to overcome the fear and get smart, become proactive and help patients avoid these infections. We need to put patients lives first .
If you do produce a program make sure it is in compliance with the latest CDC and SHEA recommendations, and then get it out there. Research what other EMS services are doing. It is important that all healthcare workers are on the same page and offering standardized and consistant courses. Almost all of my proposal for Maine comes from information that is already out there. The big difference is that I am proposing MRSA screening of high risk patients being admitted to the hospital. EMS doesn't have the luxury of screening and results of cultures. YOu do however have access to patients history and you need to ask the right questions of your patients. Are they high risk (ie cancer, diabetes dialysis, COPD, very elderly or very young, Long term care patients), have they ever had MRSA, are they caretakers for MRSA patients, do they have fever of unknown origin.......a lot of questions enter my mind. My best advice would be to treat all patients as though they have a DRO until proven otherwise. Strict handwashing and gloves are always called for....contact precautions. If the patient is coughing and feverish, put a mask on yourself or your patient if they can tolerate it. If there is lots of drianage from wounds or urine, a gown is necessary. It is much the same as in the hospital.
Cleaning or covering the stretcher with impermeable cover is important. Frequent cleaning of frequently touched surfaces is necessary.
If you want me to speak to your EMS people I would be happy to do that. You are absolutely right when you say EMS needs some serious infection control training.

My proposal to for MRSA prevention in the State of Maine finally has a title and LD number. It will be introduced to legislators in the Senate and House in Maine this week. It has taken a lot of work and several language revisions, but it is printed and ready to go.

Now the work begins. My representative Adam Goode of Bangor ME will introduce it and he will solicit support and cosponsors. We have 8 so far. Maine State Nurses Association will lobby for this proposal as well. I am very excited about this. I have never wavered on my opinion that we CAN prevent most MRSA infections in hospitals by following the right steps, with every patient, every time. Consistancy, standardization, firm policies will stop MRSA, and many other MDROs as well. The 1200 recommendations that CDC has for MRSA are confusing and weak. Standard, straight forward steps, in every hospital, for every health care worker to follow is what it will take.

My proposal includes 1) SCREENING OF HIGH RISK PATIENTS 2) ISOLATION OR COHORTING OF ALL COLONIZED AND INFECTED PATIENTS 3) PRECAUTIONS, EARLY, APPROPRIATE AND STRICT 4) REPORTING AND PUBLICIZING OF ALL POSITIVE MRSA CULTURES IN HOSPITALS 5)THOROUGH DISINFECTION OF ROOMS AND EQUIPMENT WITH EPA APPROVED CLEANSERS 6) NO DISCRIMINATION AGAINST MRSA PATIENTS SEEKING CARE IN HOSPITALS OR NURSING HOMES.

Once we pass this legislation, nurses will make this mandate work. Without powerful infection control policies, nurses are powerless to make change. After hospitals have a mandate, the rules will be the same for everybody, including doctors, nurses, support staff, cleaning personel, and administrations. The confusion and MRSA "gossip" will be gone. Transparency and prevention will begin and nurses will lead the way.

Any nurse who is interested in doing this for their own state can contact me and I would be willing to help. It is named for my father who died on January 9 this year from HA MRSA pneumonia. He went into his trusted hospital for a minor fracture of his ankle. While he rehabilitated there, MRSA invaded his lungs. He died after 3 months of suffering.