Isolation in your facility

Same Here.

I am curious what your hosptial does as far as isolation in the following instances:

positive for CDiff

MRSA in urine

MRSA in a covered wound

MRSA in sputum

My facility supposodly has policies saying all these pts are on isolation. Just curious what everyone else does

Jessica

One of the many reasons that I quit my last job was because of unsafe nursing practices at my former facility. I worked in a nursing home, and the ADON and DON both insisted that MRSA pts and C-Diff pts did not require isolation. They even did inservices forbidding personnel to wear PPE. Well, I was night supervisor, and I let all the employees working with me know that they MUST protect themselves, the pts, and ultimately their families due to high transmission rates. Well, then, a nasty letter was posted at the time clock that only the ADON or DON would decide if employees wore PPE or if pts were isolation or not. I still informed employees to protect themselves no matter what. It all boiled down to costs of using PPE and they did not want family members to see the isolation gear in use. Also, a sense of control too, I think.

In my facility the brand spanking new rule is:

When entering an isolation room for any reason, staff and visitors are required to wear a gown and gloves, even if to only speak with the patient.

Also no automatic BP's or thermometers to be used on ISO patients. Instead we have to use the broken and sometimes faulty manual BP machine in the room with inaccurate tempadots.

Also we isolate patients for anything:

TB, VRE in urine, C.Diff, MRSA in anything, and anything else that can spread easily

We place all of these type patient's in Contact Precautions/Isolation.

All of our rooms have hand sanitizers---however, for C-Diff, we MUST wash hands with soap & Water & not the sanitizers.

Our facility is EXTREMELY cautious/careful about the use of PPE's--we MUST use them!!

Every couple of months we have In-Services on some aspect of

Infectious Diseases.

We just had an issue with isolation and family members. Our hospital requires any pt with MRSA, VRE, CDiff, etc to be in contact iso- gown, glove, mask if it's sputum (or you can't stand the smell...). I had a pt's son refuse to wear PPE 'because MEEMAW would feel bad if I was wearin all that stuff'. Gaggggg.

We got the charge nurse and the policy and all sorts of shenanigans and he STILL refused. As I left there was a little standoff, with the charge nurse threatening to get security involved.

Hullo, dummy! If *I* have to do it, so do *YOU*! Don't run around here with your VRE covered hands touching the rails on the wall and the tables the in the caf.

At my facility we are required to use PPE for all patients on contact precations. These patient are also placed on " isolation". The patients are alowed to go to the dining room and to the rehab gym and any other patient areas they want to and are not required to wear any ppe to protect the people in the area or when using the rehab equipment. sorry for any missed spelling just got off a noc and home to open up AN.

It does seem that family members have the hardest time with isolation. They think because they have lived with the person they shouldnt have to wear PPE's. They dont understand that those PPE's in their case is for the protection of the rest of us and the community. Not necissarily to protect the patient or them from anything. A good lesson in why is usually in order and people for the most part will comply.

Here are my hospital's isolation policies using the original poster's situations:

1)Suspected &/or positive for C-diff: patient placed in Contact Isolation, which requires the wearing of isolation gown & gloves whenever in patient's room. Strict handwashing with soap & water(NO using the alcohol foam) is a MUST before leaving the patient's room(at minimum). Lastly, the isolation precautions MUST remain in place until the patient has 3 negative(for C-diff) stool results.

2)MRSA/VRE in urine: patient placed in Resistant Contact Isolation, which requires same precautions as Contact Isolation

3)MRSA in a covered wound: same as MRSA in urine

4)MRSA in sputum: same as MRSA in urine & covered wound, IN ADDITION to wearing a mask

**These precautions apply to EVERYONE, including staff, doctors, family, other visitors, law enforcement(in the case of a patient who is also a police hold/inmate & requires 24hr monitoring by law enforcement), etc. And just like other posters who mentioned their struggles with getting family members to comply with isolation precautions, I've also noticed MANY doctors at my hospital who DON'T follow the policies, either(except for the infectious disease doctor...he's always gowning & gloving). I'm not sure what their rational is for this &/or why they don't follow policy like everyone else.