silly mistake at work

[socalnursetob01]

Hello all,

I am a soon to be nurse her in southern california. Currently, I work in an assisted living facility. I have really enjoyed the facility as it has allowed me to develop interpersonal skills and basic care skills that I can transition into acute care one day. A bit about me: when it comes to work, I try my best to do everything by the book, especially when it comes to standard precautions with hygiene. A few days ago at work, I was caring for a resident who had just returned from the hospital due to him receiving some IV antibiotics for a chronic UTI. While at the hospital, they either found a current infection or he developed MRSA in his nares. Due to his infection, the resident (who has his own room) was sent back to my work with some topical antibiotics and put on contact isolation.

This particular day at work, I was changing the man with MRSA and getting him all situated in bed when the LVN came in to do a skin check and put his antibiotic ointment on his nose. She had asked me if I could go into another residents room and grab a couple of Q-tips to help administer the ointment. However, like a freaking "bone head", I took off my gown and gloves and left the room without washing my hands or putting hand sanitizer on before going into the other resident's room and grabbing a couple of Q-tips from his medicine cabinet.

This little scenario may not seem like a big deal, but I have been so worried that this other resident will get a MRSA infection because I was an idiot and forgot to clean my hands before going into their room. The resident's room I went into was empty (which is why I went into there to get the Q-tips) due to the fact this resident was in the hospital for another round of chemo. I only touched the door handles of the room and the box of Q-tips, but I seriously have been having visions of this poor man getting an infection due to his weakened immune system from the chemo or possibly even dying due to an infection. Are my fears justified or am I being a major weirdo for worrying about something that is very trivial and not cause anything to happen? If my fears are justified, should I tell my supervisor at work what happened so they can look out for any s/s this resident may have due to an infection caused by my mistake? Please don't read this and roll your eyes. Any feedback will most definitely put my fears aside and help me stop feeling like such a ditz.

Best,

JJ

[Gooselady, BSN, RN]

You are wayyyy over-worrying it :)

Think over the actual process of how an infectious organism is transmitted, specifically something like MRSA. It's not magical nor does it defy any known laws of the physical universe

You have to separate out, in your head, that kind of superstitious, instinctual fear of creeping, sneaky infectious organisms. It's a kind of magical thinking -- as if you could give the other patient MRSA (whether you came anywhere near him or not) simply by forgetting a step in the infection-prevention steps.

You give another patient MRSA by picking up MRSA organisms and via some form of contact, inoculating the other person with them.

Say you were doing patient care with the MRSA patient without gloves or other protective gear. You will have MRSA all over your hands. Then, without washing your hands at all, you sashay into the other patient's room to grab Qtips, and while you are in there, you have MRSA all over your hands, right? you'd have to take your MRSA-ridden dirty hands, and touch the other patient's water glass or fork or something that the patient will then touch themselves. THEN you have given the other patient MRSA.

As gross and deadly as MRSA is, it is not a magical, evil organism. It can only infect other people with assistance

So, without any magical thinking at all; you wore protective gloves and garments, which may have been covered with MRSA, right? And you removed them before heading into the other patient's room, but you forgot to sanitize your hands. It is likely that in removing your gloves and gown, you might have gotten a MRSA or two on your hands (that's why the sanitation is so important after glove removal). But nevertheless, you missed sanitizing your hands most thoroughly . . . but the good news is, all you did was grab Qtips and exit the other patients room -- without touching the patient or any of his personal items.

Chances are quite unlikely you 'gave the other patient MRSA'. But you may have planted a few MRSAs in a door knob.

MRSA is not 'airborne'. And, you need more than a single MRSA bug to infect someone anyway. Some bacteria need tens of thousands to cause infection, and some, like certain strains of Salmonella only need a few dozen or less. I don't know about MRSA.

So what I'm saying is meant to target those superstitious EWWWWW feelings and replace them with evidence-based, factual knowledge about disease transmission. It doesn't undermine the reasons we are so careful about PPE and hand sanitizing between patients (if anything, it makes it even MORE obviously important).

It's very unlikely you somehow magically infected the other patient :) And I'll bet this situation helps you to remember that hand sanitizing step :)

[jadelpn, LPN, EMT-B]

Great advice, and I can only add that the next time you are assisting with the patient, mental note--grab some q-tips to bring in with you and have in the cabinet, along with a bottle of hand sanitizer for your way out.

Best wishes!

[LittleCandles]

I think he will be okay. You could have disinfected the door handle and maybe tossed the qtips away if you were super worried.

I've always been told MRSA and other type of infections already live on surfaces and that's why it's important for us to wash our hands and not touch our faces.

[buttercup99]

You know how rooms are cleaned between a MRSA pt and the next pt taking the room? Well, you could clean or disinfect any possibly contaminated surface in the other resident's room. Ie. The doorknob and as LC said, replace the qtips or wipe down the container.

It sounds to me like the resident had a MRSA colonization vs an infection. Many ppl have a colonization of mrsa in their nares. The difference is infection is an overgrowth while colonization just means they're present, ie. he is a "carrier". So the ABs are to reduce the numbers of mrsa to limit the chance of passing it on to a non-carrier.