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.
Patient is not supposed to leave the room but technically impossible to enforce because of patient rights.
Equipment that is limited on floor must be cleaned with approved solution each time it is brought into room (long timely process)
In the quite frequent case that a cohort or private is not available, patient cannot use bathroom in shared room and must use commode...again hard to enforce. The curtain must also be pulled shut at all times around bed which in my opinion is very secluding and has negative effects on the patient.
I'm sure I'm still forgetting some policies but you can start to see the point.
There are so many open holes in "isolation precautions"....
Well, actually, I 've always been told by our infection control nurse that you can't get MRSA in your stool but apparently you can, based on looking around on line for a few minutes. But it does look like most sources, even ID journals, cite nasal swabs for MRSA only and perianal/rectal swabs as looking for VRE only. I couldn't find anything right off the bat about VRE being able to grow in nares; I wanted to double check since I was apparently missinformed about MRSA.
Specializes in Clinical Research, Outpt Women's Health.
We aren't swabbing in the rectum itself, but in 'the crack'.
That "cracked" me up!
This is another reason why i would avoid an inpatient admission at all costs. If I am with it you better believe only the nasal will be allowed. I understand the issues, but need it really be taken this far? Aren't proper precautions to prevent spread the best alternative?
If we have someone on precautions for VRE or MRSA, it's contact precautions- gown and glove. All staff have to. Visitors do not have to. All of our rooms are private anyways.
Patients may leave the room (unless they're on airborne precautions), but need to wear a gown and gloves themselves when leaving the room.
We have dedicated vital signs equipment in each room. Anything that goes in the room stays in or gets out, unless it's unavoidable, then it's cleaned.
Specializes in Cardiac/Telemetry, Hospice, Home Health.
At our hospital we have a decision tree for swabbing. Only pt's from SNF's get peri-swabbed and hospital re-admits within 30 days or those with a hx of it get nare swabs.
Specializes in Geriatrics, Cath Lab, Cardiology,Neuro.
At my facility they just do nasal swabs for MRSA. As for the whole peri-anal swab issue, this must have been concocted by the person who is related to the one who invented the hospital gown!
dnp2004 asks a good question -- "Are the facilities asking EACH patient if an opposite gender R.N./tester would present a problem? What are the protocols? "
As is typical with these kinds of questions, no one answers. Why? Are there no protiocals for what dnp2004 is asking? This procedure is embarrassing enough, it can create mistrust right off the bat, and it hurts any relationship that could be established between nurse and patient -- especially opposite gender relationships. So, why don't hospitals establish a protocal where the patient is asked right off the bat if he or she would feel more comfortable with a same gender caregiver? Is that asking too much of the system? How about some advocacy for the patient.
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systoly
1,756 Posts
I would also like to know if there are any policies limiting the patient leaving the room.