Cdiff, MRSA, VRE precautions

CapeCodMermaid, RN · Apr 16, 2010

CDiff--private room. That's it. It is a worse infection than MRSA and studies show it is going to be worse and worse. MRSA...depends where it is---sputum-private room,; nares cohort if we can or put them in a room with a relatively healthy person..one with no open areas or tubes...VRE--in the rectum who cares...in the urine...contact precautions only. People around here are more concerned over ESBL.

aaspender · Apr 18, 2010

i just had the worst week of my don life doing my annual survey. i tried to explain my policy and procedure for isolation to a very stern and egotistical federal surveyor and 10 minutes into the "interrogation" i knew i was heading straight into immediate jeopardy land. cms is really pushing the revised f441 tag for infection control and before you think any further on this read the whole million pages. it is crazy. they want to know why if 1 person on a hall is sick w/ gi symptoms that you did not test for c-diff, why they were not isolated, why... seriously, what i thought was prudent care did not fly. i think it was perhaps worse (i am being kind) because a fed was drilling me but after reading the entire thing i can see where i will have to revise our program. oh, they did repeatedly comment on how all my staff washed their hands for 15 seconds, used sani-wipes on the bg meters before each use, that every peri-care observation was perfect but still considered giving me an ij for infection control. anyway, i have a little ptsd right now and am ranting but start with the tag. as the fed guy said to me "there is this book called the som, it has the instructions... arrghhh! :eek:

CapeCodMermaid, RN · Apr 18, 2010

This kind of abusive behavior by any surveyor is unacceptable. They do not need to be purposely intimidating to do their jobs. I took my policy straight from the state DPH web site so if they have anything bad to say about it.......

take a breath and don't let the bullies get to you.

sls73 · May 10, 2010

I understand the logic of the private room with C-diff, but what if your beds are full. That is what drives me crazy- I understand the principles, realistically though it is hard to follow.

CapeCodMermaid, RN · May 10, 2010

If we don't have or can't make an empty private room, we won't admit any new person with CDiff. Luckily we haven't had a current resident with it. If we did, I suppose the person with CDiff would use the bathroom and the roommate would have to use a commode or use a different bathroom.

noc4senuf · May 11, 2010

Luckily all my rooms are private. We admitted a person two days ago.... c-diff, wound vac on the foot ( the other is amputated), VRE, MRSA, dialysis 3 days a week, PICC line, oral vanco, IV Invanz...... we won't be making any money on this one.

NurseKatie08, MSN · May 19, 2010

If we don't have or can't make an empty private room, we won't admit any new person with CDiff. Luckily we haven't had a current resident with it. If we did, I suppose the person with CDiff would use the bathroom and the roommate would have to use a commode or use a different bathroom.

We actually do just the opposite if we have to have someone with C Diff in a semi private room--C differ gets the commode, and the other patient gets the bathroom.

For Cdiff, MRSA & VRE, our contact precautions policy is as follows from most desirable to least desirable

1. Private room. (ALWAYS for Respiratory issues)

2. Co-hort with patient infected with same organism

3. Room with patient at low risk for contracting the organism (ie, not demented and touching their roommates stuff, not immune-compromised and no open wounds.) with appropriate precautions in place such as commodes, etc.

CapeCodMermaid, RN · May 19, 2010

We used to have the Cdiff person use the commode but the issue is carrying the bucket elsewhere to dump it adds to the possibility the spores will spread.