discharge of MRSA infant

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Curious as to how you guys discharge an infant who has been on isolation precautions prior to d/c. Currently we follow strict isolation precautions, then suddenly everything changes once the d/c order is written. We carry the infant out of the hospital (no gloves or gown) touching everything along the way (doors and elevator buttons) with the general population then return, scrub and presto--on to sick infants in the same clothes. Seems to be that if this is appropriate we could just use no precautions and just scrub between babies-which I know isn't right. I am not sure what the solution is but this seems wrong. Any suggestions??

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Specializes in NICU, Telephone Triage.
Curious as to how you guys discharge an infant who has been on isolation precautions prior to d/c. Currently we follow strict isolation precautions, then suddenly everything changes once the d/c order is written. We carry the infant out of the hospital (no gloves or gown) touching everything along the way (doors and elevator buttons) with the general population then return, scrub and presto--on to sick infants in the same clothes. Seems to be that if this is appropriate we could just use no precautions and just scrub between babies-which I know isn't right. I am not sure what the solution is but this seems wrong. Any suggestions??

I think once they get home, it's not as big of a concern as far as infecting others. Did the infant test negative for MRSA when he was ready to go home? I think MRSA is usually more dangerous for immunosupressed people.

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Specializes in midwifery, NICU.

I see your concerns. In our place, it's usually the person who has been caring for the +ve infant who wil take them out to the car. Sometimes it's a bit of a joke anyway, as the isolated infant will be cared for by staff in the special care nursery! We NEVER have enough staff to make it a 1-1 care, unless the babe with MRSA or similar is critical.

When these babies are discharged, we just make sure the clinics know to put them on at the end of the list, reducing the risk of transfer. What else can you do, It's a worldwide problem, so many people carry such bugs!

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My main concern is who we are exposing going out the door touching everything in sight and the RN handling the corificeat coming out of the isolation room then caring for other infants after not wearing precautions. Once our infants test positive they stay in isolation until discharge. We culture all of our infants weekly to except the ones who are positive. I was hoping for a better solution.

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Specializes in NICU, Telephone Triage.
My main concern is who we are exposing going out the door touching everything in sight and the RN handling the corificeat coming out of the isolation room then caring for other infants after not wearing precautions. Once our infants test positive they stay in isolation until discharge. We culture all of our infants weekly to except the ones who are positive. I was hoping for a better solution.

When my dad was sick in the hospital, he had MRSA and nothing special was done after he came home. I think the nurse d/cing the baby just needs to be extra cautious when dealing with infants after coming back into the unit. But, we are supposed to be using universal precautions anyway...and there is alot of MRSA out there.

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You physically carry the babies out of the hospital? On our unit, we take them down to the parents' vehicle, but only via open crib. We're taught that any baby being carried within a hospital (esp by someone who looks like staff) should raise a red flag for a possible infant abduction.

Sorry - I know that wasn't the thrust of your question, but it jumped out at me.

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Specializes in NICU, Telephone Triage.
You physically carry the babies out of the hospital? On our unit, we take them down to the parents' vehicle, but only via open crib. We're taught that any baby being carried within a hospital (esp by someone who looks like staff) should raise a red flag for a possible infant abduction.

Sorry - I know that wasn't the thrust of your question, but it jumped out at me.

We also carry the babies out to the parent's car, with the parent walking with us. i don't think this is odd. the baby is usually in a car seat.

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Specializes in NICU.

At our hospital - we carry the babies out to their parents car in their corificeat. Only RNs are allowed to carry the babies out.

As far as DCing babies w/ MRSA - we recently had one go home who was in isolation for almost her entire 6+ month stay on our unit. When she went home, the RN carried her out as usual, having the parents open all the doors and stuff. I think she wore gloves on the way down, that way she could dispose of them before she went back to our unit. She also re-scrubbed and changed her scrubs when she got back on the unit.

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Specializes in NICU, Educ, IC, CM, EOC.

Possible solution might be to have the parents carry, or have parents put baby in carrier and have them take the carrier out.

My gut tells me you are right that if the isolation has not been discontinued, it should continue out the door. I don't have any sources for you though. Maybe your Infection Control nurses might have additional guidance?

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