Published May 24, 2009
New isolation procedures on the med/psych unit where I am employed state patients from a nursing home or those on dialysis must have a nasal swab for MRSA.
If the swab is positive for MRSA, the patient must have a private room. A sign indicating contact precautions is posted on the door and PPE is available outside the door.
HOWEVER, if the patient has no draining wounds, they are allowed outside their room and are free to roam the milieu. This includes all patient common areas like the TV room and the lunch room. They are not allowed in the kitchen.
The same applies for C-diff.
Simply, I'm just not getting it. Does this make sense to anybody else?
That's the stupidest thing I have ever heard. You shouldn't just culture someone. They are most likely going to show up positive. If there are no symptoms, leave them alone. And once symptoms are gone, you really shouldn't re-culture. We aren't doing ourselves any favores with all the over kill on isolation. Some Doctors should go to an infection control class.
At the facility I recently resigned from we isolated everyone with a history of MRSA or C-Diff, regardless of how long it had been since they were first diagnosed. We never did swabs, just isolated. And all MRSA patients got IV Vanco regardless of whether they had an active infection or not. For example, a patient in DKA with a history of MRSA 30 years ago got Vanco! I have also seen them giving vanco to patients with no history and no active diagnosis of MRSA. This just does not make sense to me and I have asked numerous doc's at this facility and no one (including our infection control nurse) can give me a reasonable answer.
To the OP: yeah, that doesn't make a whole lot of sense, especially if they have active MRSA/C-Diff.
At my hospital, we put them on contact isolation if they have active or just a history of MRSA/C-Diff. Our protocol is to do nasal swabs x 2 and if they come back negative, they can be taken off contact isolation. However, if their hx was recent, such as the past few weeks, we usually just keep them on contact anyway.
edit: Wow, didn't realize I was popping up a thread this old. My bad!
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