contact precautions questions

[stayingoutoftrouble]

Probably a stupid question here but I still have trouble understanding contact precautions. So, when I have a pt. on contact precautions obviously I gown/glove with all contacts with the pt. However, what about items coming in and out of the room. I had to use a carpujet with a pt. the other day and I thoughoully washed it before bringing it out of the room. Then it hit me, what about their food tray. Those go out of the room multiple times a day...i wonder how those are handled. I am a new nurse, can you tell?

Then, it was found that the MRSA was contained only in her wound. What does that mean? Does that mean you would be okay to not use contact precaution unless dealing with the wound?

Thanks for any imput.

[TazziRN, RN]

Yes, that's what it means. You need to use extra precautions when doing wound care, but you don't have to give her paper plates for her meals.

Another term for this is "wound isolation" or "wound precautions."

[GingerSue]

how do they know that the MRSA was only in the wound?

MRSA can remain viable for days on environmental surfaces and clothing.

MRSA is spread primarily by direct contact with the hands of health care workers.

The mode of transmission of MRSA is contact; person to person, or contact with contaminated surfaces.

MRSA location is nasal secretions and skin.

Gloves are to be worn for client contact.

Gown is to be worn if soiling is likely.

Hands are to be washed with antiseptic soap.

A study done by the Canadian Nosocomial Infection Surveillance program showed that MRSA rates became ten times higher than when the study began.

[arizonanurse]

At our hospital, all meals for contact precautions patients are in disposable containers. In addition, all patient care equipment should be "dedicated" to that patient. There should be a seperate BP cuff, stethoscope, thermometer, Accucheck meter, etc. for that room only. These items are all discarded when the patient leaves. As far as the carpuject, either keep one in the room for use with only that patient or just draw the narcotic up in a syringe.

[arizonanurse]

I wanted to add that it doesn't matter if the MRSA culture came from the wound...you still initiate contact precautions. And any MRSA culture from the past (for example, you have a patient admitted that had a MRSA positive culture a year ago) means contact precautions until you get a negative culture.

[jen123321]

I totally disagree with that...MRSA lives everywhere and definitely is not just contained to the wound persay. That's why theres such a thing as contact precautions...