I am wondering how your ER deals with contact precautions.
On the floors we place all pts with any MRSA/VRE history on contact precautions. In the ER this is not even looked at! I often don't even find out a pt has a MRSA history until they are admitted to the floors! Yes, we wipe down the stretchers between pt, but I don't wear gloves/gown up for every contact, which I would be doing if I were treating these pts on the floors.. Just doesn't make sense to me.
Does your ER flag a pt immediately when they have a MRSA history on record? How does your ER deal with infection control?
I barely see bp cuffs being wiped down between pts! The ER is a scary place for infection control.
Specializes in ED, Neuro, Management, Clinical Educator.
The electronic medical record in use at my hospital alerts everybody that opens the chart if a patient has ever had anything requiring isolation in the past. The header with their name and medical record number is a different color to signify the need for isolation. We observe the same isolation practices in the ED as they do anywhere else in the hospital. Patients are also placed on isolation precautions if a viral culture (aka "flu swab") is ordered, and maintained until the final results are in (not the preliminary result, the final result 24 hours later.)
The electronic medical record in use at my hospital alerts everybody that opens the chart if a patient has ever had anything requiring isolation in the past. The header with their name and medical record number is a different color to signify the need for isolation. We observe the same isolation practices in the ED as they do anywhere else in the hospital. Patients are also placed on isolation precautions if a viral culture (aka "flu swab") is ordered, and maintained until the final results are in (not the preliminary result, the final result 24 hours later.)
Our "big board" of pts, which is on our computer, indicates if a pt is on isolation. If the physician orders a flu swab, they are marked isolation by the computer until results come back.
The electronic medical record in use at my hospital alerts everybody that opens the chart if a patient has ever had anything requiring isolation in the past. The header with their name and medical record number is a different color to signify the need for isolation. We observe the same isolation practices in the ED as they do anywhere else in the hospital. Patients are also placed on isolation precautions if a viral culture (aka "flu swab") is ordered, and maintained until the final results are in (not the preliminary result, the final result 24 hours later.)
And then, when their minor complaint is treated, they are sent on their way, back to their job as a food handler. And the waiting room, where they actually spent more time, is not sanitized in any way. Neither is the pen and clipboard they registered with- it was just given to that immuno-compromised little old lady.
Hospitals are full of potentially dangerous organisms, of which MRSA is one. These organisms are regularly spread from person to person, despite any attempt at prevention.
I just had a patient who had obvious hygiene issues, who had big red oozing thingie on his belly. He had been squeezing it and draining it with his dirty scabby hands. I have no idea how many things he touched in 2 hours, but I can pretty well guarrantee that less than half of them were cleaned. I'd say there was a 50/50 chance the the pulse oximiter was cleaned after his finger, gleaning with exudate, was in it.
Hospitals are disguusting, disease ridden places, and should be avoided- especially if one is sick.
Specializes in Emergency, Critical Care Transport.
Flagged immediately. All patients who are admitted to the hospital are given a nasal swab, regardless of "risk" - patient could be a healthy woman on the L&D floor giving birth or a septic bomb going to the ICU.
All of our rooms, aside from the "holding area" are single rooms, multiple are negative pressure capable, and all curtained areas are 15' from the next gurney.
Housekeeping is regularly paged and responds to MRSA/VRE cleans. They rock, and are under-appreciated.
I don't ever want my nose swabbed. I know who's coughed on me.
We have isolation carts all over our ED.
But then again, our hospital is seriously going for Magnet.
nfdfiremedic, BSN, RN
60 Posts
The electronic medical record in use at my hospital alerts everybody that opens the chart if a patient has ever had anything requiring isolation in the past. The header with their name and medical record number is a different color to signify the need for isolation. We observe the same isolation practices in the ED as they do anywhere else in the hospital. Patients are also placed on isolation precautions if a viral culture (aka "flu swab") is ordered, and maintained until the final results are in (not the preliminary result, the final result 24 hours later.)