Help with Isolation Guidelines for MDRO's

[bobnurse]

Hi,

Needing help.

Patients with colonized MDRO's such as MRSA, VRE, ESBL, and etc.....

Do you isolate (Contact precautions).

We isolate (contact) for all MDRO's, c-diff, acinetobacter, ESBL's and etc....I have seen facilities in other states only provide standard precautions for colonized patients.

So....what is the current recommendations and can you provide a link so i can use it for reference. I have looked at CDC and it states contact precautions.

also, if you have a sample policy that i could review.

We are a semiprivate 31 bed specialty hospital and are bedlocked at a census of 23 d/t colonized MDRO's. So i am looking to see if we are right in our current practice of Contact Precautions for everyone or if Standard is ok for colonization.

Thanks for your help.

[cfaith]

Here is the what my agency does

1. Enhanced Standard Precautions (see Multi-Drug Resistant Organisms IC 103)


1. Used to reduce the risk of transmission of multi-drug resistance organisms (MDROs) from patients that are colonized or whom have containable or non-draining wounds. ENHANCED STANDARD PRECAUTIONS will be considered on a case by case basis.
   
1. Only patients with known or a history of MDRO that are dependable and reliable to carry out proper hygiene and wound care can be placed on Enhanced Standard Precautions.
   
2. Place known colonized or infected patients in a private room. If private room is not available, use a cohort placement system.
   

Roommate criteria are as follows:

• The roommate is not immunosuppressed. (e.g., HIV+ or Dx of AIDS, on steroids, neutropenic, S/P chemotherapy)
  
• The roommate does not have a different MDRO.
  
• The roommate has intact skin.
  
• The roommate has no indwelling devices.
  
• The roommate is able to cooperate with infection control measures.
  
1. All wounds will be covered with a dressing at all times using disposable and/or designated patient care equipment.
   
2. All staff must adhere to strict Universal Precautions at all times while providing direct care or handling patient belongings. Soap and water hand washing is the preferred method of hand hygiene. However, waterless preparations can be used until the first opportunity to use soap and water is reached.
   
3. Patients placed on Enhanced Standard Precautions will receive infection control education from nursing staff which will be documented in the patient record. This education will include proper hand hygiene and wound care information pertinent to the infection. Education must include instructing the patient not to share any personal hygiene items.
   
4. Patients placed on these precautions will be required to shower last or have a designated shower made available. All towels and linens are to be handled as contaminated.
   
5. Patients should not be allowed to participate in any activity that would involve close body contact (i.e. sports, swimming) if the wound or drainage cannot be contained or the draining integrity maintained.
   
6. No signs are to be placed on the door of the patient’s room.