MRSA isolation... should it be done for years?

Katie91 · Aug 2, 2009

I had a patient last night. She had MRSA back in 2002. Had no open wounds of any kind, except her fresh incision. The nurses on the previous shift put her in isolation when she came back from surgery because she had not had 3 recent negative swabs for MRSA. There was no mention of MRSA in the doctor's history. After gowning and gloving every 20 minutes for several hours, I finally called the nursing supervisor to discuss the situation. She said it was rediculous to isolate the patient for something that happened 7 years ago so I took her out of isolation and her care was greatly streamlined. Being a weekend, the infectious disease nurse wasn't available. Anyone have experience with this... is it really warranted to isolation a patient for something that happened years ago?

This happens ALL of the time in my facility and yes, we all find it rediculous. If the pt has no signs of active infection and their MRSA of the nares is neg on the current admission, why exactly are we doing this??? :banghead:

I did look up the protocol on the CDC website a few months back (after being infuriated with having 4 out of 6 pts on iso for a Hx MRSA the day prior) and it states that there must be 3 consecutive neg nares screenings to keep the pt out of iso. I would love for the Powers-That-Be at the CDC to spend a shift gowning and gloving every time their pt(s) have lost their call light, need their pillows fluffed, etc.. I guarantee the protocol would quickly change.

Mammy1111 · Aug 15, 2009

Apparently most hospitals regard any known previous MRSA positive patient as a currently positive MRSA patient and they do isolate. Locally they do not even rescreen to see if they test positive. This does seem extreme, but the CDC doesn't have a recommendation when to stop isolation of known MRSA patients. Of course the current CDC recommendations tend to contradict themselves all over the place so who knows what the right approach is. They need to address this issue.

It is time for the CDC to step up and do the math so to speak. If a patient has not had any MRSa outbreaks in a number of years and the nasal screening is negative, it seems reasonable to allow them to be roomed with someone. The science needs to be determined before this is considered a safe approach though.

Personally, I don't think healthcare staff can do too much to prevent MRSA. If you have lost a loved one because of MRSA, you tend to feel this way.