M.R.S.A.

kewlnurse · Feb 27, 2001

Originally posted by snickers:
Was just wondering about the prevalence of M.R.S.A. in hospitals out there.
What kind of precautions are used, what kind of protocols are followed.

Thanx in advance for your input.

sj.

We see cases on our ortho floor occasionally, usually off service patients who need an isolation room and we have the only ones available. MRSA is bad stuff when it gets into a prosthetic joint. The prosthesis must be removed (this is true of any infectd joint, not just MRSA infections) and an antiobiotic spacer is placed for usualy 6-12 weeks, a picc is put in and they eventualy go home on iv abx unitll clear, than they get surgery again. We have different protocols for location of the infection, contact, respritory and strict. We have several ID md's that screen the patients and order abx for them, usually gent/vanco and i've seen a few with a new one who's name eludes me right now. Once you have MRSA your prone to get it again, so if we get an admission who has had it in the past they automaticaly go into isolation untill they are cleared by the ID MD.

bugladyrn · Jun 26, 2001

I work as and ICP for a 60 bed rehab facility. MRSA is a big problem in this area and as the main rehab hospital we get most of the nasty germ from other facilities. We have a very strict policy here for MRSA and VRE. I have had approx. 20 cases of MRSA sent here since january of this year. We screen all incoming patients and determine if they are at risk, then we have the sending hospital culture. This prevents spread as all but three of our rooms are semi-pirvate. Since these patients are here for rehab therapy I have made arrangements for them to be out and participate in therapy. These patients have private rooms and staff still uses appropriate PPE, but the patient may still attend therapy as longer as the drainage from the wound is contained, the cough is non-productive(patient wears a mask), and the patient is continent. I have alos created a simple to read and follow isolation guidelines book for my staff. I found the policies were never read and everyone had a different idea about how isolations were treated. The book makes it all straight and in black and white.

yoshiko yanase · Nov 5, 2001

I work at "Acute medical ward" in New Zealand. Precaution for MRSA is quite good here. We screen income clients if they come from other hospitals or rest home, and also if clients has history of MRSA. We take swab for 3 times initially (do culture), and clients are isolated until it has been cleared. We normally use gown, mask, gloves to deal with isolated patients, include precautionary isolation. We also have infection control nurse to contact whenever we want to ensure the guideline, of course infection control protocol is always available to read in each ward. The protocol has individual guideline for specific disease that we can refer to.

However, when I looked nursing research articles related to infection control for my degree paper, there is not much research done by NZ nurse. I hope it will increase as it is significant issue for nurse as well as other medical professionals. If you would like to find out what sort of research articles I have found please do contact me I am willing to advise you the details of the articles so you can locate them.

Carolyn T · Apr 9, 2002

I am a home health pediatric nurse. Tomorrow I will be bringing home a 2yr old with MRSA (lungs) and Pseudomonas. I plan on using gown, mask, gloves of course and there is a mask already there. This child has a twin and a new baby sister 3wks old. I'd like any experience you'd like to share with this kinds of situation. Am I right in thinking his room should basically be an isolation type room and the twin be kept OUT of there? Have any of you had MRSA patients in home care? If so, how did you handle things? I think I'm probably just looking for reassurance here that I will not become colonized and bring this home to my 2 new grandbabies.

bernarma · May 13, 2002

Carolyn T,

Is the MRSA an active infection or colonized?

There are people everywhere you go with MRSA these days. They do not stay home confined to a room. They live their lives. BUT as usual the key is in good handwashing!! Too bad nurses adn DOCS in general do not comprehend that.

Curious to hear how it has gone for you so far.

bernarma · May 13, 2002

Carolyn T,

Is the MRSA an active infection or colonized?

There are people everywhere you go with MRSA these days. They do not stay home confined to a room. They live their lives. BUT as usual the key is in good handwashing!! Too bad nurses and DOCS in general do not comprehend that.

Curious to hear how it has gone for you so far.

boblen42 · May 13, 2002

Dear sj,

Im working here in UK. Presently,we have cases of MRSA in NICU. Since, this is an open NiCU, parents can come and stay with their babies for them to be involved in their baby's care like nappy changes and breast feeding.Even the relatives can visit with the parent's consent. And one thing more, our unit is on ongoing expansion that is why babies are really at risk of having an MRSA.

HANDWASHING is really the most important in preventing MRSA. what we are doing here is, we nursed the contaminated patients in isolation room with en suite WC and wash hand basin. The door should be kept closed and an isolation notice should be posted. We used disposables gloves and apron. In cleaning the room, inform the domestic to use separate cleaning equipment.

MRSA carriage site swabs must be taken from the nose, axillae, groin and perinum. In addition, swabs must be taken from the following sites as applicable: wounds, eczema,pressure sore, leg ulcers, IV cannula sites, wound drains, stomas including tracheostomies. Swabing can be done to patients who are at risk during their admission and stay in the hospital.

I hope I can share some points for you.