MRSA and Home Care

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Specializes in ER, L&D, ICU, LTC, HH.

I have a question for people just to know what others are dong. What is your agency doing to prevent MRSA spread in home health care? Do you have any good links for this?

Thanks

~Willow

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Not a thing. It has never been mentioned at any agency.

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Specializes in ER, L&D, ICU, LTC, HH.

We have a hospital that has told two of our patients who had MRSA prior to leaving the hospital that they got it from the home health nurses. This was MD's and nurse's saying this. It just got me thinking about our risk using BP cuffs from one pt to another and such. Anyone else have any precautions they are taking?

~Willow

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I had been taught somewhere along the line to clean the BP cuff (between patients), but it wasn't in response to anything specific. Just something I learned along the way and it was not taught to me in nursing school. In a LTC facility one time we had someone who came up with MRSA and I was appalled that it was not addressed so that the CNAs and everyone was made aware. That place was a trainwreck anyway, so no wonder this fell through the cracks. I suppose that if it came up it would be addressed individually, but to be quite frank, the agencies I'm with at this time don't seem to care much about anything. I can see them not saying a word. Heck, they don't even think we need to know the name of our nursing supervisors!

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Specializes in COS-C, Risk Management.
We have a hospital that has told two of our patients who had MRSA prior to leaving the hospital that they got it from the home health nurses. This was MD's and nurse's saying this. It just got me thinking about our risk using BP cuffs from one pt to another and such. Anyone else have any precautions they are taking?

~Willow

I just wonder how exactly they knew it was the home care staff that spread the MRSA? Did they culture every other patient at the agency? All the nurses? I find it much more likely that it was contracted during a hospital stay.

In any case, your precautions will depend on the location of the infection. All cases should require gowns, glvoes, and shoe covers. If it's respiratory, then you'll need a mask as well. Put on PPE's upon entering the pt's home and take off as you exit, place in a biohazard bag, then double bag if soiled and/or you think it requires it. Place in pt's outdoor trash container or in your biohazard waste container in your car (if you have one--and you really should). I also keep a change of clothes--right down to shoes, socks, and underwear--in my trunk, just in case. The pt should have their own disposable VS equipment provided by the HHA, a disposable isolation kit, so that you don't bring any supplies into the home that you will then have to take out. If you're on laptops, find out what you need to do to obtain pt's signature for the visit that doesn't require you taking the laptop into the home. And make sure that all of these supplies are on your 485 for billing purposes.

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Specializes in ER, L&D, ICU, LTC, HH.

Thanks for the replies. I would think maybe each pt having their own BP disposable cuff might help, because we admit wounds all the time that are infected and even if you wipe the cuff with cavity wipes MRSA can be cultured out. I never take my bag in with really dirty wounds or homes. There has to to be some ways to cut down on the risk for cross contamination and nurse's safety. Wish we had a concrete home health set of protocols for all pts to prevent any possible complications. Anyone else have any other suggestions not already mentioned?

Thanks!

~Willow

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Specializes in ER, L&D, ICU, LTC, HH.

I found this link it is a good pamplet for patients I think.

http://www.health.state.mn.us/divs/idepc/diseases/mrsa/book.pdf

~Willow

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I have seen disposable plastic sleeves that were used as a barrier between the pt and BP cuff. You might check with your agency director to see if these could be ordered.

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We have a hospital that has told two of our patients who had MRSA prior to leaving the hospital that they got it from the home health nurses. This was MD's and nurse's saying this. It just got me thinking about our risk using BP cuffs from one pt to another and such. Anyone else have any precautions they are taking?

~Willow

In the hospital I worked we had these special super antimicrobial wipes. housekeeping, (or us if we needed one asap) would wipe down the MRSA/CDIFF isolation blood pressure equipment, including the cuff, upon patient discharage for reuse with the next patient. This was just last year, we did not have disposable eq.

I would think on EBAY u could find some for personal use if u are that concerned, or just use clorox any surface wipes or spray which do kill MRSA.

ALSO Little known MRSA facts for those who care. FIRST: Know that their are different degrees of MRSA virulance...their is little MRSA that comes up from a nasal swab in the general public and the mega MRSA that comes mostly from the hospital setting..that is the stuff that eats through ur flesh in 2 days ..u get the point. (im waiting on the lecture now haha..yes i know all MRSA is bad hehe) But many people are colonized. Second, colonized MRSA, can hide inside the cells of the body...so you can sterilize and whatever all you want and it still might not matter....Of course we still have to try to prevent it's spread but let's face it...most of us are colonized and i dare say that many patients that have spent any amount of time in a LTCF or hospital are colonized...

MRSA almost killed my Dad following CABG. Thank god he is fine today...he had a deep sternal osteomylitis infection and even became septic. Then it became Vancomycin resistant. This was 2005..his bloodsugars were 600 and up the whole time he was in the hospital but no insulin Drip! instead they sent a dietician to lecture him(he wasnt eating much anyway). 5 surgeries later (he now has no breastbone) and 5 months later they got it all cleared out...I thank God everyday that I still have my dad..I was 25 and very little medical knowledge.

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Specializes in WOC, Hospice, Home Health.

We have "MRSA kits" that consist of a disposable bp cuff and stethoscope, plus we can use gowns/gloves/goggles as needed. Haven't actually seen the kits in many homes though. In theory, if bag technique is followed to the letter (paper towels under bag, anything that comes out of bag and can't be cleaned stays in patients home, proper cleaning of reusable equipment) then transmission from one patient to another shouldn't be too much of an issue.

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Specializes in Hemodialysis, Home Health.
I found this link it is a good pamplet for patients I think.

http://www.health.state.mn.us/divs/idepc/diseases/mrsa/book.pdf

~Willow

That is really a GOOD one ! :up:Thanx so much !

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Specializes in ER, L&D, ICU, LTC, HH.

This is cool. I found this on site someone else posted.

http://www.hopkinsmedicalproducts.com/product.jsp?path=-1|466&id=547

Blessings

Willow

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