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.

[kittle81]

Funny you should mention cost. Just last night a new memo was posted about these swabs stating that the hospital pays for them and they should not be done if the pt is already known to have a history of MRSA/VRE/Acenitobacter to save on cost. If say they are a known history of MRSA in the sputum/nares, we would not do that swab- only the peri-anal for VRE/acenitobacter.

Who knows. But yeah, I doubt they'll start swabbing any of the staff. How many of us have been in a room, right in a patients face for 3 days only to come back the next night and see an isolation sign up? Tons, I'm sure.

[BertinaRN, ASN, RN]

We also do the peri-anal in some cases, and I have never had to do one on a patient who had a negative result for nasal, they always screen the nasal first.

[DeLana_RN, BSN, RN]

As a pt, I would simply refuse ANY swab. Why? Peri/rectal is too humiliating and nasal wouldn't be a problem, except for this reason: the hospital where I would like to work again (and where I would likely go as a pt) terminates any nurse who has ever had MRSA! I don't know how common this is, but it surely is a powerful incentive for nurses to make sure they never learn their MRSA status.

As a pt's nurse, I would make sure I emphasize to the pt that s/he has the right to refuse.

DeLana

[morte, LPN, LVN]

As a pt, I would simply refuse ANY swab. Why? Peri/rectal is too humiliating and nasal wouldn't be a problem, except for this reason: the hospital where I would like to work again (and where I would likely go as a pt) terminates any nurse who has ever had MRSA! I don't know how common this is, but it surely is a powerful incentive for nurses to make sure they never learn their MRSA status.

As a pt's nurse, I would make sure I emphasize to the pt that s/he has the right to refuse.

DeLana

how did the hospital get away with this? ah, never mind, TPTB gets away with anything until we fight back......

but i would wonder how they managed this, without culturing the entire staff, on an ongoing basis....

[dnp2004]

So let me get this straight; doctor, nurses, and other healthcare workers who routinely come in contact with scores of patients are not routinely tested?! This has to be an Aprils Fools Joke!

[SandraCVRN]

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

That was my thought.

[chickie]

We have also started doing rectal swab, groin swabs and nare swabs as our protocol. We were told that all hospitals throughout the US were now doing this procedure to help stop the spread of MRSA and VRE. We do our swabs every Monday until or unless the patient tests positive.

[rnmi2004]

I can see where the hospital is coming from, I guess.

I'd still have to refuse the swabbing, and strongly encourage any hospitalized family members to refuse.

[dnp2004]

I still go back to the point that the program is inherently flawed if there is no requirement that all the healthcare workers be tested on a regularly schedule as well. Can anyone else see my point?

[morte, LPN, LVN]

dnp....i understand your point, but the powers that be dont really care about the patient, they are simply trying to save money,,,,,and culturing their help would only cost money

[Beverage]

Why would your employer be looking at your medical chart? That would be a big time HIPAA violation.

Life Insurance often make you give them access to your medical records as a condition of acceptance for a policy. They can use the "pre-existing medical condition" clause to deny payment for services.

[ayla2004, ASN, RN]

nasal and perianal is stanard practice for all pt on pre admisoon checklist on on admissison

we do wounds, piv, cvc, folerys and peg/pej sites