Nosocomial infections

mommatrauma, RN · Jun 26, 2005

So...
the hospital where I'm doing clinicals is currently trying to eradicate a rash of Legionnaire's disease. We're actually bathing pts with warmed bottled water. It worries me a little, since I don't have the greatest immune system r/t rheumatoid arthritis. How do you cope with being frightened of this kind of thing? I'm very, very new at this, and I'm still a wee bit freaked out by pts on contact precautions, esp. since this hospital doesn't necessarily have dedicated bp cuffs in contact rooms. When I asked the CNA what I should use to disinfect a BP cuff I'd used on a contact pt, she looked at me like I was from Mars. Do you just get over it after you go a couple years without getting sick?

First of all, Legionnaire's is not spread person to person, no special contact precautions are needed. It is spread through water sources usually inhaled or aspirated. The incubation period of Legionnaires' disease is from two to ten days; this is the time it takes before symptoms of the illness appear after being exposed to the bacteria. For several days, the patient may feel tired and weak. Most patients who are admitted to the hospital develop high fever often greater than 39.5°C (103°F). Cough can be the first sign of a lung infection. The cough may be sufficiently severe to cause sputum production (coughed up mucous). Gastrointestinal stomach symptoms are common with diarrhea being the most distinctive symptom. Many patients have nausea, vomiting, and stomach discomfort. Other common symptoms include headaches, muscle aches, chest pain, and shortness of breath. Smokers, chronic lung disease pts and transplant patients on chronic corticosteroids are higher risk...most patients symptoms will resolve in a few months, with a c/o of general weakness and malaise as the most common complaint after dc from the hospital...Most patients will recover completely within a year. Serious sequelae are rare...

As for what to clean equipment with...your facility should actually have a policy on what should be used for what types of equipment or body fluid contamination...if you still aren't sure, you can either ask the environmental services/housekeeping dept, or check with infection control for better help.

As for protecting yourself...standard precautions pr precautions for whatever the isolation category is and proper handwashing and you should feel at ease that you are protecting yourself...

Aneroo, LPN · Jun 26, 2005

I've always used Dispatch to clean my supplies if I have to take it in somewhere I don't want to. Of course, I try not to! -Andrea

begalli · Jun 26, 2005

For our isolation rooms we have dedicated disposable equipment that does not leave the room. If something goes into the room and has to come out (eg: a fan, IV pumps/poles, pressure bags, keofeed pumps, pillows, etc), it's labeled biohazard and sent to central for cleaning. We toss the disposable stethoscopes and cuffs when the patient is d/c'd. I NEVER use my own stethoscope on these patients.

It's absolutelty nasty to think that equipment is not being cleaned between patients even if they aren't in isolation.

begalli · Jun 26, 2005

It worries me a little, since I don't have the greatest immune system r/t rheumatoid arthritis. How do you cope with being frightened of this kind of thing?

Follow universal precautions even if others do not. Don't wear gloves outside of patient rooms and wash your hands!

I think I must have a rock solid immune system - nothing can penetrate it. I have worked in healthcare for about 17 years. In the beginning, I used to get colds and the flu, but I haven't been sick (knock on wood) for years!

I think it's EXTREMELY rare that a healthcare worker end up "catching" something from a patient. I admit that the whole SARS thing a couple of years ago was a little bit scary though.

I don't have the time, but maybe you could do a google search on the odds of a nurse "catching" something from a patient. It's pretty slim.