MRSA screening of staff....

[sauconyrunner]

• I did a search and I found some threads but none that I found were recent, so I thought I would pose the question here.
  

One surgeon at our facility wants to have all the Operating Theatre staff swabbed for MRSA screening.

I am not against this or actually for it. Some of our patients do come back with Post op MRSA infection. It is not, however, the predominant micro-organism that is infecting our patients. (Since most patients go home after many big procedures it's hard to know exactly where they got the infection when it is a superficial infection, not a deep or organ space infection.) While we do not screen our patients (unless the MD wants to) all our Pt's are decolonized the day of surgery regardless of screen or no screen.

I was asked to investigate the legal side of this, as well as the practical side. So far all articles I have looked at seem to support the screening and treatment of staff. Sadly most indicate that staff usually become re-colonized and their MRSA becomes more resistant to the treatments. So, it seems like it is not worth the expense.

Anyone have any information they can point me to? Especially about the re-colonization. Its tough as most articles only followed the people de-colonized for 3-6 weeks... THanks all. This is an infection control topic really, but I think more eyes will see it in general nursing!

[blondy2061h, MSN, RN]

So what happens when people come back for MRSA? They lose their job?

[deemalt, BSN, RN]

Good luck! We probably all would screen positive. It would be an interesting study but like the previous poster stated, what would be the consequences?

[sauconyrunner]

No... they are treated. and can come back to work when clear. Just like any other infectious disease. Problem is that people can become re-colonized. I don't have a problem treating staff etc, but...I don't want it to be a revolving thing, and frankly speaking those who test negative can also later become carriers....

Now over the years we have found a few people who were chronic carriers of other things due to psoriasis and other conditions (fingernail infections). When they could not completely clear the infection they did have to be reassigned from the Operating Theatre, as they were the source of the infections. But they were not fired. It was unfortunate if they truly loved the OR but...no one wants to be a typhoid Mary either. (One was a lady who actually only delivered supplies. She was perfectly happy to deliver supplies to other parts of the hospital.

[blondy2061h, MSN, RN]

So then who is paying for all this sick time while people are out being treated for something that little evidence suggests can be completely cured? Who is staffing the OR while people are out being treated? I'd be ticked if I was put on antibiotics for an asymptomatic colonization and then got c-diff. The more we use antibiotics the more super bugs like MRSA we'll see.

[loriangel14, RN]

I don't think that you can become "recolonized". Once you are colonized you stay that way don't you?

[NRSKarenRN, BSN, RN]

[h=3]MRSA Infection: MRSA Hospital Staff[/h]

[JZ_RN]

If I wasn't sick I wouldn't be taking antibiotic medications for an asymptomatic "infection" and I would not be getting put out of work because of something I probably picked up AT work. There's a reason we scrub, glove, and gown.

Patient safety is important but at the price of staff safety, health, and autonomy in their own lives and health.... no. It's a privacy issue too.. I mean, my workplace is not privy to all my personal information, I have privacy under HIPPA too. There's a reason we use standard precautions.

[Sun0408, ASN, RN]

If you don't test all pre-op pts how do you know they didn't have MRSA before the surgery ?? Sounds like staff is being blamed for something the pts themselves could already have. Im not sure but I don't think one tx will de-colonize a pt. We treat ours for 5 days.

[Sun0408, ASN, RN]

Oh and I hope that one surgeon will swab him or herself with the rest of the staff..

[nerdtonurse?, BSN, RN]

I'd love for someone to do a study of the people entering a Walmart on a given Saturday morning. I think you'd find there's a lot more MRSA out there than people realize.

[tcvnurse, BSN, RN]

A hospital in Florida back in the mid eighties got the bright idea to swab all the nursing staff in an effort to decrease MRSA infections. Well guess what they found? Every single one of the nurses was colonized!! That figures, you might think. Well the hospital was not about to treat all those nurses. So--

They stopped culturing the nurses! I find it sort of funny and sad that that was the result.