I asked a co-worker if she had a blood pressure cuff I could borrow tonite at work. She had me follow her to a room with contact precautions, and provided the cuff for me. I questioned whether or not I could use the cuff on another patient, she stated that the patient has MRSA in his urine, and it didn't come in contact with that, so it will be ok.
My gut continued to question this, so I took the cuff and wiped it down thoroughly with alcohol pads before using it on my patient. Can anyone clarify this for me?? If a patient has MRSA, no matter what kind, shouldn't they have their own equipment designated to that room?
Our hospital will put someone on contact precautions even with just a hx of MRSA. So even if 5 years ago you have cellulitis that was positive for MRSA and is now cleared up, you will be placed on precautions.
Anyone coming from LTC, homeless, or even a transfer pt gets automatic nasal swab.
If all hospital staff were to get swabbed, I would believe that a large percentage would be positive too.
Our hospital will put someone on contact precautions even with just a hx of MRSA. So even if 5 years ago you have cellulitis that was positive for MRSA and is now cleared up, you will be placed on precautions.
Anyone coming from LTC, homeless, or even a transfer pt gets automatic nasal swab.
If all hospital staff were to get swabbed, I would believe that a large percentage would be positive too.
I disagree with the only using gloves if MRSA is in urine. How many times have you taken care of a patient for several days and the very next day or even during your shift they get placed in isolation for MRSA. I think if its in the urine it could also eventually be in the blood or wound. Better to be safe. As far as swabbing hospital staff, they did that in our facility a few years back, and yes many tested positive for MRSA, colonized of course.
Good questions and I agree with your critical thinking. Trays are removed by gowned/gloved personnel (may be nursing or dietary) and are placed in a separately contained area of the meal cart. If the cart leaves before the isolation tray is picked up, it's picked up with contact iso protocol and carried directly to the kitchen. I don't know why they don't just use disposable trays/utensils.
A tray from any patient's room should never go to the kitchen area on the unit; always to a cart immediately, or to the soiled utility room. Taking it to the kitchen area just serves the bug up to everyone else around.
No one ever with a gown and gloves on should ever enter a clean area like a kitchen.
Remember MRSA is a staph bacterium and it is not limited to growing only in health care settings or compromised patients. Anywhere any staph species can grow MRSA can be potentially found. It has long ago escaped into the community and we must be mindful that anyone can acquire this infection in the community at large.
Not that I am minimizing the need for precautions in documented MRSA infected patients but we must realize that it can be found almost anywhere.
A tray from any patient's room should never go to the kitchen area on the unit; always to a cart immediately, or to the soiled utility room. Taking it to the kitchen area just serves the bug up to everyone else around.
No one ever with a gown and gloves on should ever enter a clean area like a kitchen.
So what's the solution? If it goes to the soiled utility room, who knows how long it sits there? And once it leaves there to go to the kitchen, how is it supposed to go? If it goes by cart, how does it get off the cart once it's in the kitchen? There are several potential points of contamination between leaving the isolation room and the kitchen.
A tray from any patient's room should never go to the kitchen area on the unit; always to a cart immediately, or to the soiled utility room. Taking it to the kitchen area just serves the bug up to everyone else around.
No one ever with a gown and gloves on should ever enter a clean area like a kitchen.
That should be a given.
Even worse, I have known techs AND nurses to use the microwave and freezer in the unit's kitchen to reheat or freeze dirty warm/ice packs that had been in use on patients. I've actually had them argue with me when I've instructed them to throw out the food in the freezer (along with the ice packs from patients with known VRE and MRSA infections!!) and have the frig/microwave disinfected.
There were rules in our hospital that staff could not partake of nutritional supplies, drinks, etc., from the patient kitchen. Believe me, it wasn't because of that rule I didn't do so...
EmmaG, RN
2,999 Posts
I think they should--- with everyone. But the public won't go for that.