Do you swab for MRSA upon admission?

  1. We have started this in the past few months since Medicare is going to try to deny payment for nosocomial infections. We have found a small percentage of kids that come from DR with it! We had one with CA-MRSA that ended up with pneumonia and eventually needed a lobectomy because it was eating his lung! Now that is scary! Our OB is talking about swabbing moms now too.

    What do you think or do?
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  3. by   preemieRNkate
    We don't in general, only for babies transferred to us from NBN or another hospital that are >24 hours old.
  4. by   elizabells
    All outside transfers (outside hospital or the very rare from-home) get swabbed for MRSA, VRE, and ESBL. We just had a kid come in with flu A!
  5. by   Sweeper933
    Our entire hospital swabs EVERY patient for MRSA upon admission, and then again every Sunday night during their hospital stay. We've had babies test negative the first few, then positive after that.
  6. by   Imafloat
    We only swab the babies who come to us from another level III nursery.
  7. by   dawngloves
    We only swab transfers, but maybe now we should swab all admissions!
  8. by   SteveNNP
    What Elizabells said..... my last unit swabbed all admissions, and caught quite a few CAMRSA cases before we got blamed for it. We also used to swab colostrum, because we had a few cases of the baby getting in from mom's milk. Stopped doing it though, because it was so rare.
  9. by   elizabells
    I've only seen it once where we thought baby was born with it - a 2do kid with pustules clustered in his axillae, which the visiting fellow insisted were baby acne. I finally talked another doc into ordering cultures, and lo and behold, MRSA! Turns out mom's bad "acne" was, uh, not acne.
  10. by   chescat58, RNC-NIC
    We swab admissions that do not come from the L & D ie transports or transfers. We swab every tuesday. Some kids are postitive early and some late. Our community has over 50% with MRSA so most of it is brought in by visitors.
  11. by   Gompers
    We swab every baby on admission and then every baby gets swabbed every other Tuesday for their entire stay. I believe the entire hospital is now doing this as well now. I do have to say that for all the MRSA-postitive babies we've had, I've never once seen any of them actually SICK from MRSA. They are just colonized with it and stay in isolation until discharge. We used Bactroban one time and it did work - baby was negative after one week - but I don't know why we don't use it anymore.
  12. by   RainDreamer
    Almost 2 years ago we were mandated by the state to swab all new admissions and all outside transfers. I think we were mandated to do so because we had a ton of MRSA going around.

    We don't do it anymore. We put a lot of things in place that has made our infection rate go way down, below the national average. I can't remember the last time we had a kid with MRSA.
  13. by   NICU_babyRN
    We swab every single patient upon admission and every monday morning until discharge. When a baby does have mrsa they are given Bactroban and must have 3 consecutive weeks of negative swabs in order to come off isolation.
    I believe any patient admitted to the hospital is swabbed upon admission.
  14. by   RainDreamer
    Back when we did have kids with MRSA, they NEVER came out of isolation. Once they went into isolation, even after they tested negative, they stayed there until discharge.