I think peri/rectal swabs are a humiliating 'welcome' to the hospital

[FireStarterRN]

On some units we are starting MRSA screening on all new admits. They have to agree to it, of course. We are supposed to do a nasal and a peri-rectal swab. I was on a unit that just started doing this, it was their opening day of this new policy so I had to ask all my patients to allow me to do this screening. A couple of the patients allowed both areas to be swabbed and a couple only would let me do the nasal swab.

The whole peri/rectal swab thing is demeaning, in my opinion. What a way to start out as a patient at a facility! You have to put on a patient gown and proffer your backside to the nurse, after being asked a bunch of embarrassing questions.

This is why I hate the whole healthcare system whenever I am in the patient role, which has been rare. No wonder people feel powerless. There are a lot of things that contribute to the stripping of human dignity in our healthcare system, and this peri-anal swabbing has got to definitely be in the top 10 list.

[marie39]

Our hospital does this too...I hate having to ask every single patient to do the peri-rectal swab. It doesn't seem to help because we have a c-diff outbreak anyway?!

[EarthChild1130]

I think that's absolutely awful...personally if I were a patient I would refuse to do it, and if I worked there I would be demanding to see what evidence-based practice they use to justify that...:trout:

[Nascar nurse, ASN, RN]

Personally, I think we have gone way over the edge with some of this. Lets treat the symptomatic infections and leave the rest alone. Aren't we all suppose to be using universal precautions anyways. Any of us (staff and patients) are subjected to a multitude of "bugs" in every grocery store, library, etc that we enter.

My local hospital is also doing nares and peri-rectal swabs.

[APRN., DNP, RN, APRN, NP]

Many hospitals in my area are implementing this requirement, as per newly enacted legislation in California dictates MRSA screening.

No hospitals in my area require swabbing the nether regions upon admit - only the nares.

[AirforceRN, RN]

We swab both for every admit. If you are "lucky" enough to have known MRSA you are excused from the swabs. On a previous ward we swabbed every patient (except known cases) every Thursday.

I'd be pretty ticked if I shared a bathroom with a patient who refused a perirectal swab and then caught MRSA due to his lack of hygiene.

[flyingchange]

I just learned how to swab on Monday. I agree, 3 different locations kind of seemed overkill. Plus my 40-something pt was mortified that I had barely introduced myself and then was poking his rear with a Q-tip.

[VivaLasViejas, ASN, RN]

How absolutely humiliating.

I can understand the nasal swab, but if somebody were even to approach my nether regions with a Q-tip, I know where I'd put it.......and it wouldn't be in MY backside, I can assure you.

[nursel56]

Maybe it's related to the "never event" rules where Medicare Medicaid will not pay for the cost of treating a MRSA infection. They need to know if a patient had a MRSA infection at the time of admission, so cannot be held liable for a positive culture while as an inpatient

[XB9S, BSN, MSN, EdD, RN, APN]

We swab our pre-op patients in a pre-assessment clinic 4 weeks before admission, we swab nose throat and groin which are our own local protocols. For groin swabs we ask our patients to swab themselves if they are able

Hospital Infection Society have issued guidelines in 2006 (remember these are UK guidelines) but they are evidence based.

[blondy2061h, MSN, RN]

We swab both for every admit. If you are "lucky" enough to have known MRSA you are excused from the swabs. On a previous ward we swabbed every patient (except known cases) every Thursday.

I'd be pretty ticked if I shared a bathroom with a patient who refused a perirectal swab and then caught MRSA due to his lack of hygiene.

Yeah, ours are every Monday. And that's just 1 reason why I think shared rooms are inappropriate.

I still don't get why you aren't letting your patients do their own swabs. Most people can manage to find their rectum with a cue tip, and you'd have a lot higher compliance rate with it.

[dnp2004]

I just learned how to swab on Monday. I agree, 3 different locations kind of seemed overkill. Plus my 40-something pt was mortified that I had barely introduced myself and then was poking his rear with a Q-tip.

Are the facilities asking EACH patient if an opposite gender R.N./tester would present a problem? What are the protocols?

[FireStarterRN, BSN, RN]

Maybe it's related to the "never event" rules where Medicare Medicaid will not pay for the cost of treating a MRSA infection. They need to know if a patient had a MRSA infection at the time of admission, so cannot be held liable for a positive culture while as an inpatient

I imagine that has something to do with it.