Patient has MRSA in urine, what do I do?

[mzsuccess]

Hello,

So long story short. I put in my notice at my current job (4 days left) and accepted a home care position for 15 hours, in which you are allowed to sleep overnight ( and get paid) basically you’re working 6 hours with the patient.

I've worked with this pt four times this far.

However, last night the pt begin to tell me how he had MRSA in his urine and was hospitalized he reports this being a few years ago. I asked the director ( business owner) she says he only have traces of MRSA, he wasn’t ever on precautions or anything.

I really like this case and pt but now I’m paranoid working there and thing is I have eczema that breaks out on my arms and hands which comes in contact with pts sheet. What should I do?

[MSO4foru, ADN]

Use isolation precautions when in contact or potentially in contact with body fluids.

[MSO4foru, ADN]

MRSA is abundant. If the pt knows they have it this is a plus.

[K+MgSO4, BSN]

Don't drink his urine?

Discuss with infection control of the hospital that he attends. Isolation precautions in the community are different to hospitals, find out what they are and follow them. VRE, CPE and candida auries are much more concerning to me...and norovirus due to the high frequency of transmission.

[mzsuccess]

He is a homecare pt who I’m taking care of. The other nurse says he only have traces in his urine but we change his foleys out and things like that and MRSA isn’t ever fully cured correct? My thing is it’s no ppe and I wouldn’t have known if he didn’t mention

[Rose_Queen, BSN, MSN, RN]

12 hours ago, mzsuccess said:

MRSA isn’t ever fully cured correct

Patients can indeed be decolonized/have their infection treated with antibiotics and no longer be carriers or infected with MRSA. It's the reason that any patient admitted to my hospital with a previous MRSA infection automatically goes into isolation until surveillance cultures are completed. If the surveillance cultures are negative, the isolation precautions are discontinued. It is not necessarily a lifelong infection.

[mzsuccess]

2 hours ago, Rose_Queen said:

Patients can indeed be decolonized/have their infection treated with antibiotics and no longer be carriers or infected with MRSA. It's the reason that any patient admitted to my hospital with a previous MRSA infection automatically goes into isolation until surveillance cultures are completed. If the surveillance cultures are negative, the isolation precautions are discontinued. It is not necessarily a lifelong infection.

I don’t know what to believe. Per the NP/ owner the patient was never diagnosed and he’s sorta a hypochondriac. She said he only has traces and hasn’t ever needed precautions. But the pt says he was in the hospital about something else and MRSA was found in his urine and had to take antibiotics.

[Rose_Queen, BSN, MSN, RN]

What do you mean by “traces”? Either the urine culture grew out MRSA or it didn’t. Antibiotics very well could have eliminated the infection.

[Crash_Cart]

On 8/6/2019 at 10:21 PM, mzsuccess said:

I have eczema that breaks out on my arms and hands which comes in contact with pts sheet.

So basically you hypothesize the cause of this "eczema" is the pt's previous hx of MRSA.

So what should you do? Well you need confirmation of your hypothesis utilizing the methods of scientific investigation.

[VivaLasViejas, ASN, RN]

Two words: Standard Precautions. They will help you stay safe from all kinds of little germies. Use gloves, don a gown, eyewear, and/or mask as appropriate if you're dealing with things that are warm, wet, and not yours. And wash your hands each and every time you touch a patient, both before and after. You should be fine. ?

[Ponymom2]

Are you wearing long sleeves?

[Jedrnurse, BSN, RN]

4 hours ago, Crash_Cart said:

So basically you hypothesize the cause of this "eczema" is the pt's previous hx of MRSA.

So what should you do? Well you need confirmation of your hypothesis utilizing the methods of scientific investigation.

I interpreted this to mean the OP has a condition that makes her/him more vulnerable to picking up an infection due to the impaired skin integrity.