a question about MRSA

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We have been getting patients from the hospital who are positive for MRSA. We put them on contact precautions. As staff we know what we should do but will the patients roommates be in danger of getting it? We have many patients who "borrow" each others dentures, etc.. :p I guess I may be to cautious about spreading this around but we have 6 residents with this, 2 just returned with positive tests.

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Oh yuck yuck yuck :eek: sharing dentures :eek: :eek: :eek:

How easily MRSA is will spread will depend on where the MRSA infection is - urine, blood, wound etc. Not really a good idea to share dentures if they were MRSA +ve nasal mucosa. Not a good idea to share dentures full stop me thinks :cool:

Kay x

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Specializes in Gerontology, Med surg, Home Health.

EEEEEEEEEOOOOOOWWWWWWWWWWWWWW denture sharing...ugh! Can't you collect them at the end of the day and give 'em back in the morning?...about the MRSA...put the ones with it together, saves the 'clean' rooms for other patients. And, I think, if you have MRSA one place, there's a pretty safe bet you'll have it in another. :barf02:

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We have been getting patients from the hospital who are positive for MRSA. We put them on contact precautions. As staff we know what we should do but will the patients roommates be in danger of getting it? We have many patients who "borrow" each others dentures, etc.. :p I guess I may be to cautious about spreading this around but we have 6 residents with this, 2 just returned with positive tests.

Can the MRSa positive residents be put in a private room? If not they can be cohorted. I don't think it is a good idea to cohort denture swappers. I would only cohort a MRSa + resident with a clean resident if the one w/o an isolation issue did not have a foley, GT, dialysis, denture swapping tendancies, etc.

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And, I think, if you have MRSA one place, there's a pretty safe bet you'll have it in another. :barf02:

An infection of MRSA can be confined to one area such as the blood or urine. When we screen for MRSA we swab from a number of sites eg nose throat perinium wound etc and act accordingly.

Kay x

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Specializes in Med-Surg.

I guess this is why we screen all LTC residents when the come to our hospital for MRSA, and a good number of them have colonies, particularly in the nares.

Strange that you use contacat precautions but allow them to have roommates.

We cohabitate people that have the same infection in the same site. I'd be careful that the roommates aren't too frail. The problem with MRSA is that it can make the frail and immune compromised patients sick. The well residents, the nurses, etc. aren't going to get sick and we all are probably walking around with staph colonies on our bodies somewhere. This is what I'd be careful, if a roommate catches a cold or is sick, then I would separate him/her from a MRSA resident until they feel better.

Are these roommates teachable? Can you ask them not to share stuff like that?

Sharing dentures???

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I know all these patients were positive in the nares, that is the only place we check. If they have wounds or open areas should we swab it too? Yes we have room to put them in private rooms or together but that is not the policy. We can't take their dentures out of their room, company policy. Some of the patients are with it, but even with it one is very noncompliant. He is a big yuck in that he is diabetic, has sores on his leg stumps and if we aren't careful he takes the banadages off and Licks them.:barf01:. The other morning 11-7 caught him licking the bm smears off his underwear.:barf01::barf01: Luckily he is already in a private room but he is all over the facility. If we have more than 6 patients with the flu or such we are supposed to quarantine them to one area. I think this would be the best solution.

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Specializes in Med-Surg.
I know all these patients were positive in the nares, that is the only place we check. If they have wounds or open areas should we swab it too? Yes we have room to put them in private rooms or together but that is not the policy. We can't take their dentures out of their room, company policy. Some of the patients are with it, but even with it one is very noncompliant. He is a big yuck in that he is diabetic, has sores on his leg stumps and if we aren't careful he takes the banadages off and Licks them.:barf01:. The other morning 11-7 caught him licking the bm smears off his underwear.:barf01::barf01: Luckily he is already in a private room but he is all over the facility. If we have more than 6 patients with the flu or such we are supposed to quarantine them to one area. I think this would be the best solution.

That's just nasty. Yuk!

Yes, if they have wounds you need to culture those too. If they have MRSA there, they need to be on antibiodics. Good luck.

Aren't there any standards from CDC or JACHO about this kind of stuff. Sorry, I don't do acute care.

Good luck.

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We have a res right now with MRSA in his blood and sputum. Last sputum culture a week ago was positive for 2 colonies. He is in a private room - resp precautions. We will be doing another sputum next week to see if he is still colonizing or not. And as a foot note: he has his own teeth! :chuckle

Also when he goes out of the room for therapy or whatever, he wears a mask.

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Dinkymouse

how is it possible to "allow" residents to share dentures???? Just remember instruct fellow nurses CNAs housekeeping etc to glove up and wash hands! Years ago we used to "isolate" such residents but with proper infection control we shouldn't have to.

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I think everyone is misinterpreting this denture thing....If you have spent any time at all in a LTC facility, you will eventually find someone with someone else's denture in their mouth. This is not purposeful...you have to remember, lots of these folks are still ambulatory, but very demented....and they wander into other residents rooms and dig through their stuff. This occ results in the whole denture swapping thing. I know one facility I went to tried to have everyone's family have their dentures inscribed...but that is costly and not everyone would do it.

Kathryn

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