MRSA Colonization in Healthcare workers and patients - page 3

Four percent of healthcare workers MRSA-positive reveals results of a study of MRSA prevalence in healthcare workers. Very few studies have been done regarding this subject. Every nurse I spoke... Read More

  1. by   horus2001
    the question is MRSA colonization the same as having TB. if it is, then no nurse can be fired:

    ADA Who's Disabled, 11/92 NRPA Law Review

    this link explains that, a communicable disease is covered under the ADA and the nurse must be offered an equal job since an RN can fill other roles than direct patient care, the hospital is likely to be obligated to offer another postion:

    "As noted by the Court, "[a] person who poses a significant risk of communicating an infectious disease to others in the workplace will not be otherwise qualified for his or her job if reasonable accommodation will not eliminate that risk." Accordingly, the Court acknowledged that "the Act would not require a school board to place a teacher with active, contagious tuberculosis in a classroom with elementary school children."
    "An otherwise qualified person is one who is able to meet all of a program's requirements in spite of his handicap." In the employment context, an otherwise qualified person is one who can perform "the essential functions" of the job in question. 45 CFR 84.3(k) (1985). When a handicapped person is not able to perform the essential functions of the job, the court must also consider whether any "reasonable accommodation" by the employer would enable the handicapped person to perform those functions. Accommodation is not reasonable if it either imposes "undue financial and administrative burdens" on a grantee, or requires "a fundamental alteration in the nature of the program."
    Where reasonable accommodation does not overcome the effects of a person's handicap, or where reasonable accommodation causes undue hardship to the employer, failure to hire or promote the handicapped person will not be considered discrimination".
    Given the "paucity of factual findings by the District Court", the Court found itself "unable at this stage of the proceedings to resolve whether Arline is 'otherwise qualified' for her job."
    Employers have an affirmative obligation to make a reasonable accommodation for a handicapped employee. Although they are not required to find another job for an employee who is not qualified for the job he or she was doing, they cannot deny an employee alternative employment opportunities reasonably available under the employer's existing policies."
  2. by   P-medic2RN
    Not only would the hospitals have to pay for tx and swabbing, but think of the money, workers comp would have to pay out.
  3. by   Mammy1111
    Yes, think of the money they would have to pay. But, why shouldn't they? Nurses are willing to put their lives on the line for patients. Hospitals fail to enact effective preventative measures (in the case of MRSA, ADI) they are liable for their HCWs exposures and subsequent colonization and or active infections.

    The answer to it all is to prevent the infections in the first place. Safer and infection free patients make for safer and infection free HCWs....fewer exposures to infection.
  4. by   mercurialnerd
    My family (3 of 5 members) have been battling CA-MRSA infections for 9 months. We have been advised by the doctor in charge of infectious disease to undergo a decolonization regime. (We have already tried the Mupirocin and Hibiclens thing more than once.) What this consists of is what he referred to as 'chemical warfare', including a course of Rifampin for all affected family members. This is a TB drug that can cause liver failure. My daughter just turned 13 & she is one of the people who is presumably colonized. Considering the chemical warfare is only 70% effective and we can go out in the community the day after and pick up CA-MRSA again, I do not consider it worth the risk. I do wish public awareness was higher. (People, it is NOT a spider bite. See your doctor today, not a week later when it's out of control.) First line of Tx is Bactrim. Not a 'sexy' drug, but there's a reason for using it first: MRSA does not develop resistance against it. By the time we knew what ailed my son last summer--the classic 'ingrown hair'--it was too late for oral antibiotics and he had to go with the Vancomycin, which is notorious for encouraging MRSA resistance. (Unfortunately an allergic reaction to Bactrim (sulpha) is not unusual, which is why I have to use Clindamycin now.) BTW, when I was hospitalized for my allergic reaction to the Bactrim, I was in isolation (my husband & child had to gown up to visit me), but the healthcare workers were not routinely tested. Huh?
  5. by   mercurialnerd
    P.S. The average length of time for colonization is six months. Yes, your file will be marked for life, but it doesn't mean a darn thing, because other people who haven't ever been tested might unknowingly have it & acquire an infection post op or spread it to their hospital roommates. Hopefully the day will come in ALL states that everyone is tested pre-op, but so far this isn't the case...
  6. by   mercurialnerd
    So...if everyone went on the decolonization regime consisting of the Rifampin course, wouldn't MRSA become resistant to Rifampin? This I don't understand.

    An ENT I saw recently, who's fearful of contracting MRSA (understandably), swabs his nostrils with Mupirocin on a regular basis. Don't do it! MRSA has been known to develop resistance against Mupirocin, too--in Australia, if I remember correctly.