VRE and MRSA screening

[ragingmomster, BSN, MSN, RN]

I work in an L&D unit with 7 LDRP's and 16 LDR's. The LDR's usually have high risk pt's in them.

New policy handed down today and starting next week is that anyone who arrives in pre-term labor or PROM will be assumed to be VRE/MRSA positive and will be swabbed and put on contact precautions. All staff entering room and all visitors entering room will wear protective gowns. Visitors get a clean pt gown and staff the lovely yellow paper gowns.

VRE perirectal swab will take 2 days and MRSA 3 days, or vice versa. By the time we know their status the pt will most likely be discharged. Infection control states this goes for all inpt areas in this hospital and we are the last unit to implement.

Anyone else using a similar policy?

[JaneyW]

Never heard of something like that. Do you have a problem with VRE and MRSA in your facility?

[CEG]

Funny... are all patients treated that way? Seems pretty strange to assume someone is VRE or MRSA postive. Is it assumed an infection has caused the PROM? I am not a nurse yet, so I am curious.

[babynurselsa, RN]

Nope never heard the like.

[RNnL&D]

Infection can be a cause of PPROM or PTL, but I've never heard of assuming it is VRE/MRSA. No policy like that here.

[rnmi2004]

VRE perirectal swab will take 2 days and MRSA 3 days, or vice versa. By the time we know their status the pt will most likely be discharged. Infection control states this goes for all inpt areas in this hospital and we are the last unit to implement.

Anyone else using a similar policy?

So is infection control stating that patients in all inpt areas are subjected to VRE & MRSA testing, and until results come back negative contact precautions are in place? Sounds expensive to me.

[beautifulb]

So, every pt. that comes into the hospital is on contact precautions? That seems kind of extreme. How many gowns do they go through? Goodness.

One place where I worked did MRSA and VRE swabs on the pt's when they were admitted (actually the pt's may have been from outside facilities -- I can't really remember) but they were placed on universal precautions until the swabs came back.

[dawngloves, BSN, RN]

I've never heard of MRSA or VRE being a cause of PTL or PROM.BV and maybe GBS. Do they have a study to back this up?

[grandee3]

Same here beautifulb, our facility did that for a while and we used UP unless swab came back +. Why they did this? We don't really know. But, patients who were freq flyers always asked as soon as they hit the door, "do you have to do that swab thing in my butt?" We did'nt like it and the patients hated it. However, we did it because it was a pilot program and could have led to better control of MRSA & VRE.

No longer work there, nobody does, it was destroyed in Katrina.

[CIRQL8]

My institution is doing that in ICU only (at this time). Assumed isolsation until proven otherwise.

[BittyBabyGrower, MSN, RN]

We just started this also...the reason being that we have had 3 preemies die in the past 4 months from MRSA...and when they swabbed the mom's they were the carriers. One case was necrotizing MRSA....CA-MRSA . This is the "flesh eating " type and it was in the kids lungs and ate thru to the ribs. It was awful. All these kids were vag. Do you have a NICU that has had a high rate of MRSA?

Do a search on MRSA or necrotizing MRSA in preemies and there are a few articles.

[ragingmomster, BSN, MSN, RN]

We have a 50 bed level 3 NICU and don't have a problem with MRSA or VRE there. Apparently we are the last unit in the hospital to go online with this program and it has been approved by the senior attendings here. I am betting it will be discontinued when we see the cost of gowns go sky high.

Thanks for all your responses, it is nice to know I can get other opinions on our "crazy" policies.