afraid I may have spread mrsa

[luellamae]

While helping another nurse reposition a patient who had MRSA of the urine, I only donned gloves. My uniform touched the bedrail and when I came out of the room I wiped off the front of my scrub with alcohol. Now afraid, what if I spread mrsa to other patients. I was always vigilant with handwashing. Should have worn the gown. Live and learn, learn, learn.

[luellamae]

thank you all for the words of wisdom....I have read so much on the subject now.....I still worry after reading due to the fact that mrsa is on surfaces and of course the bedrail is a surface and the patient was incontinent....I have come so far since then in my career and wish I could get rid of the haunts from those days

[RNsRWe, ASN, RN]

Contact precautions is to wear protective clothing IF "soiling" is likely......"brushing the bed" with your uniform isn't "soiling" unless the bed was soaked with urine.

Ah, but the standard contact precautions called for in every hospital I'm aware of states that prior to entering the room of an isolation patient, if there is to be ANY CONTACT with that patient or ANY ITEM in that room, the employee is to gown and glove properly. It's understood that "soiling" can be merely moving a MRSA-laden object from Point A to Point B.

If the front of one's scrubs is rubbing a contaminated surface, then yes, that person is at risk of transferring the microbes picked up on the scrubs to ANOTHER person's bedrails--and there starts your next infected patient.

I don't feel it's terribly likely the OP infected anyone. However, if she had been spotted in an iso room ungowned/ungloved by a certain Infectious Disease MD I know, he'd have had her head on a platter.

[CountyRat]

Yes you should have gowned, but no, you are not a bad person because you did not. You were in a hurry and you took a shortcut that was a mistake. We have all been there. Learn from it, and move on.

PS: I always had a set of scrubs with me when I worked ICU, in case my uniform got soiled. Just a thought.

[sauconyrunner]

Because of the way MRSA sheds the chances of your uniform being contaminated are actually pretty high.

And while patient do not touch your uniform you do touch it quite frequently. I'm an infection preventionist, and yep If I saw you doing what you describe, you and your manager would be having a close door talk. It is not an acceptable action, and breaks all sorts of policies and it does put you , your family and patients at risk.

THat said, others have also done this. MRSA is spread in hospitals, usually by Health care workers. I work very hard to remind people that they should you know, wash their hands, etc but we still get a few patients each year who obtain MRSA, VRE or even CRE in the hospital- free of charge from health care workers, nice huh?

As there is NOTHING you can do about the past, I would just forget it, and I would be sure my practices regarding iso were stellar, and I'd insist that everyone elses were too. If you are still having sleepless nights about this, you may need to really think about why...because you can only change the future.

[sauconyrunner]

It has been the rule for about the last 4 years that isolation patients can leave their rooms.I'm not sure of the reasoning.

We don't have that policy, but it is probably based on the theory that Nurses and health care worker are going from patient to patient, but the Iso pt is just going ambulating in the hallway... hopefully not from pt to pt. I would not be a fan of this policy!

[mariebailey, MSN, RN]

Even though there is a true potential for spread, & contact precautions are warranted, MRSA is more likely to be transmitted from person to person via colonized hands, rather than fomites, such as clothing, linens, & surfaces. You may have made a mistake, but at least you washed your hands! I hate learning the hard way; I feel your frustration!

[conroenurse]

IT's EVERYWHERE, IT"S EVERYWHERE!!

LOL (well maybe not funny)

What really SLAYED me was post hurricane Katrina we had patient with open wounds and MRSA who would dig at her wound, and later be out in hallway, on elevator, outside....etc. and hosp refused to do any isolation or protection to others on her due to TRAUMA of hurricane. OMG, so many of us were hysterical for ourselves and our patients. Finally had a nurse come in whose job was walk by her and spray/wipe all she touched, and she was threatening lawsuits the whole way...

[sauconyrunner]

IT's EVERYWHERE, IT"S EVERYWHERE!!

LOL (well maybe not funny)

What really SLAYED me was post hurricane Katrina we had patient with open wounds and MRSA who would dig at her wound, and later be out in hallway, on elevator, outside....etc. and hosp refused to do any isolation or protection to others on her due to TRAUMA of hurricane. OMG, so many of us were hysterical for ourselves and our patients. Finally had a nurse come in whose job was walk by her and spray/wipe all she touched, and she was threatening lawsuits the whole way...

I would have hated to be the spray and wipe nurse!!!

Gowns are a huge expense at our hospital, so if they really were not needed, you betcha, we'd get rid of them.