Contact precautions in the OR?

[brewerpaul]

I'm curious how people out there handle patients in the OR who are on contact precautions.

Sometimes we'll have, say, a foot ulcer debridement where the MRSA is actually in the surgical site. On other patients they may have tested positive for MRSA several years ago in a wound that has long since healed. However, BOTH are still on contact precautions unless they get "cleared".

How do you handle these patients? Do you do the yellow gown and gloves thing every time you go in or out of their OR? Kinda tough to go out, take off the garb, grab one suture then re-don everything. This could happen 20 times in a case!

In our OR, we bring these patients directly into the OR rather than letting them sit in our holding area. When we go to PACU, they get put into a separate area if it's not already occupied. However, we do NOT do the gown and gloves thing for all casual contact.

What are you all doing?

[Rose_Queen, BSN, MSN, RN]

We do gown and glove until the patient is draped as circulator. Once the drapes come off, the gowns go back on. The techs usually just keep the sterile gown on until the patient leaves the room. Anesthesia wears gown and gloves the whole time. As for preop, we have one slot dedicated to isolation patients, but if it's late in the shift we use the pacu isolation room, and then it only needs cleaned once.

[maeyken]

Our hospital treats it pretty black and white... either they are +ve or -ve. Patients who are +ve get all contact precautions for the entire case, PAR, etc. -ve patients are treated like any other patient (just standard universal precautions).

For MRSA/VRE/etc cases, we usually have someone in the core who can get stuff for us, so that as a circulator you can stay in the room and don't have to constantly re-gown and re-glove. When I'm circing I usually put on 2 pairs of gloves, then I can just change the outer pair if they get contaminated, but I can wear the other pair for the case.