student assigned pt with respiratory MRSA

Nurses General Nursing

Published

I'm a 1st semester nursing student and have been assigned a patient for my first physical assessment. The pt has COPD, Lung Cancer and has MRSA in her lungs. I have to say, I'm a bit freaked out by it. Kardex calls for contact precautions and a mask if coughing. I'm concerned if a simple mask is enough. Should I wear eye protection? I don't want to be wimpy, but I'm nervous about the respiratory MRSA. Any suggestions? My clinical is tomorrow morning. Thanks in advance for your advice.

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

I read somewhere that most healthcare workers are MRSA colonized. Sorry I don't have the article for direct reference. As said before you are at about the same risk or more just going to the store...no PPE there!

Oh gees. Just gown and glove. If the pt is coughing up phlegm at you, then you can wear a mask. Wash your hands.

Probably 20 people at the grocery store that you went to last had resp mrsa...

And probably ALL the nurses you work with!

If they ever decided to culture nurses to find the path of infection, we would ALL be out of a job.

I read somewhere that most healthcare workers are MRSA colonized. Sorry I don't have the article for direct reference. As said before you are at about the same risk or more just going to the store...no PPE there!

Here's a recent article (2010) with MRSA statistics amongst healthcare workers. The bottom line? MRSA was found in 4 percent of healthcare workers with most strains related to healthcare.

http://www.medscape.com/viewarticle/719841 or

http://www.fiercehealthcare.com/story/four-percent-healthcare-workers-mrsa-positive/2010-04-07

EXCERPT:

"Of the healthcare workers tested, 4.3% were MRSA-positive. Among those involved in direct patient care, 4.6% were positive; among nonclinical staff, 4.2% were positive. In addition, three quarters of healthcare workers involved in direct patient care who were positive were infected with a healthcare-related MRSA strain, compared with just over half (54%) of nonclinical staff (P ≤ .052)." END EXCERPT

The latter sentences above must be read carefully. The writer refers to three quarters of the healthcare workers WHO WERE POSTIVE (that's 75 percent of the 4.6 percent). Later in the article, the writer also refers to 54 percent of nonclinical staff and MRSA infection rates (meaning 54 percent of 4.2 percent) --The author leaves it to the reader to be careful and aware that the author is referring to the subsets. --I think unclear writing and rapid scanning by readers can contribute to confusion.

do what makes YOU comfortable. i'm one of those people who wears gloves for EVERYTHING and i don't give a crap what anyone thinks. people think it's "no big deal" until they go to take a BP and a pt forgot to mention they just picked a scab or they go to clean up a bedside table and touch a rag with snot all over it. making a bed? yup, i got gloves on. like i said - do what makes YOU comfortable.

Specializes in Burn, CCU, CTICU, Trauma, SICU, MICU.

MRSA, gown and gloves, wear a plain old mask if you'd like. :)

Specializes in Hospice, ER.

I probably have everything under the sun and then some. MRSA isn't as scary as it sounds. But when you are in nursing school follow the precautions exactly. When in clinical practice, you will probably be in and out of the pts room dozens of times before you are notified that they have MRSA, VRE, TB, etc. When in doubt, gown, glove, and mask.

Specializes in tele, oncology.

If it makes you feel any better, I got a pre-op swab a couple of years ago and was negative for MRSA...after years of taking care of patients with it. And I gotta admit to not always being the most vigilant about PPE. (Just don't tell my IC nurse :) )

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

Thanks for the articles. My info is much older and as I now recall it was given to us in an in-service and was specific to ER staff. Apparently it was thought we were at a higher risk because the patients come in and haven't been identified as MRSA positive until after contact with them.

Thanks for the articles. My info is much older and as I now recall it was given to us in an in-service and was specific to ER staff. Apparently it was thought we were at a higher risk because the patients come in and haven't been identified as MRSA positive until after contact with them.

You're welcome. I do think you are right that ER staff is likely at higher risk. I also suspect that some hospitals are more at risk than others, depending on the population they serve. One of my nursing school instructors said it was best to glove with ALL pts. I think she was right. I have often seen pts admitted and several days later put on contact precautions. Handwashing and sanitizing are important.

I think other posters were right, that the OP is getting a good lesson early on. I also think that it will be less scary for the OP over time. ---And, I think the statistics show that contact precautions are keeping rates lower in healthcare workers (although they are at higher risk per the 4 percent infection rate which is higher than in the gen pop).

:)

You guys spurred me to look for additional data. It was good to get updated, for me, too.

'Ello people. We know it- the OP doesn't. She's a first semester nurse, so sure, she can be freaked out.Don't get so far-gone in your experience that you forget your first time.

OP, freak out all you want and when your head settles, reread the post, get as much information as you possibly can on MRSA, then apply it and deal with it.

Good luck on first day of clinicals:)

Here's a recent article (2010) with MRSA statistics amongst healthcare workers. The bottom line? MRSA was found in 4 percent of healthcare workers with most strains related to healthcare.

http://www.medscape.com/viewarticle/719841 or

http://www.fiercehealthcare.com/story/four-percent-healthcare-workers-mrsa-positive/2010-04-07

EXCERPT:

"Of the healthcare workers tested, 4.3% were MRSA-positive. Among those involved in direct patient care, 4.6% were positive; among nonclinical staff, 4.2% were positive. In addition, three quarters of healthcare workers involved in direct patient care who were positive were infected with a healthcare-related MRSA strain, compared with just over half (54%) of nonclinical staff (P ≤ .052)." END EXCERPT

The latter sentences above must be read carefully. The writer refers to three quarters of the healthcare workers WHO WERE POSTIVE (that's 75 percent of the 4.6 percent). Later in the article, the writer also refers to 54 percent of nonclinical staff and MRSA infection rates (meaning 54 percent of 4.2 percent) --The author leaves it to the reader to be careful and aware that the author is referring to the subsets. --I think unclear writing and rapid scanning by readers can contribute to confusion.

Wow, this IS news; I would have expected the numbers to be MUCH higher, dealing with it as we did for so many years before tighter controls were mandated.

I guess we all just have fabulous immune systems dealing with what we do, as I can't even begin to count the pt.s I admitted to the hospital who went 2-3 days off isolation before the cultures came back positive.

Thanks to those who remember what it's like to be brand new! RNfaster - love the evidenced-based information. Seeing that only a small amount of health care workers have MRSA is very informative. We don't have to freak out about it - but it's NOT something to be casual about like some nurses think.

+ Add a Comment