trixter

I just discharged a pt who had been admitted for iv antibiotics for a knee wound that tested positive for MRSA per a wound culture. I consulted our hospital infection specialist before initiating "MRSA teaching" because of course, there are questions that are not included in the pamphlet you give the patient. She said that unless the patient has a nasal swab done in the future, there is no way to know if the MRSA is colonized in his body (his wound has healed since admitted) so the following procedures should be followed at home by all family members/visitors as long as the wound is closed/healed: hand washing/sanitizing, wiping counters/surfaces with Lysol-like products, washing linens and towels in hot water, and pt to use tissues after sneezing/coughing. She said MRSA is fairly easy to get rid of with these precautions and that they are precautions that are good for even non-MRSA households to follow. Of course, as I walked him out, he asked if he could use his hot tub. I told him that he should make sure that the wound is totally healed (as in, you don't see evidence of it). I wish I had more time to research that, but it sounded like a common-sense answer. I suppose he could seal it, or hang his leg out of the tub...Didn't think of that until now. Oh well.....

If you create your report sheet you can customize it over time. My original sheet had room for 3 patients; now it has 5. (I'm not too thrilled when I have to use a second sheet!). I also leave an empty space to write in things I verbally want to report to the next shift. The "timeline" that someone else mentioned is really useful for me. I have a vertical line to the left of a blank column represting each hour (7, 8, 9) and I circle the time that I know I have to give a med, check a blood sugar, follow-up on whether a pt has urinated spontaneously since the foley was removed.... Good luck!

On our med-surg floor, surgical patients typically have both, plus we change the teds every shift (at least on days and pm's) for comfort and to avoid having the teds "cut into" the patients' legs which of course would defeat the purpose of the teds!