VRE

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I was wondering if I should put a resident on Contact precautions that has positive rectal cultures for vre from their stay at the hospital and has been readmitted to the nursing home with no treatment?

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Specializes in Emergency & Trauma/Adult ICU.

CDC - VRE in Healthcare Settings - HAI

CDC recommendations in link above. What does your facility policy state?

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If they were VRE positive then yes, they should be on contact isolation. For our patients in LTC they would have a bedside commode, or briefs if they were incontinent. There was some controversy about this as if the stool is contained then why the need for isolation? Also, if the pt has VRE they should not have a roommate with anything invasive, foley, central lines, or an open wound of any type. You certainly do not want the VRE to be spread to the other residents. Hopefully, the one who has it is not a patient who plays in their stool.

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Specializes in Psych, LTC/SNF, Rehab, Corrections.

Were you at work when you wrote that...? LOL.

"Hmm. What to do? What to --I know. I'll log and pose the question to ALLNURSES and wait for someone to post an answer!"

Yeah - tell the aides to get the room ready. I always temp move roommates even if in it's in their poop/urine bc I work psych. it can be difficult to maintain strict iso in psych facilities. People play in their poop. People wander in and out of rooms. People wander, period. It's not impossible, though.

Why are you asking internet folk what to do when youve got an a/don, coworkers and a physician on speed dial? You shouldve told the MD/NP about their status when you called to clarify orders.

You didnt do this.

The resident wld be isolated, no questions asked, if you did. Thered be a med order, if you did. You guys would be throwing some form of - mycin snatched from your ER kit down their throat until pharm could send a courier by morning or COB, next day...if you did.

"Should I --"? There is no option. You relay pertinent info, always. What the doc chooses to with it is...whatever they choose to do with it. Keep them on iso, relay to oncoming shift and CYA in your nurse note. CYA, always.

Are you a troll or a new nurse?

If youre legit? Apologies.

It just seems off ... what you're saying. I'm not trying to be difficult and nitpicky but what IS this? LOL

You not knowing when to put a pt on iso is half the problem. You wouldnt be wracking your brain if you did admits properly...and youre not. Basically:

Assess.

Review paperwork

Compare hospital meds to Mar

Clarify orders c provider AND inform of pertinent info.

Fax meds to pharmacy

Create dietary slip AND comb through that paperwork to ensure that a pt on a reg diet isnt really a reg diet mech soft, for instance.

Get orders in.

...and somewhere between throwing down orders and getting the pt acclimated to the facility be sure to write a nice nurse note.

When youre taking report, youll be given a rundown on all that had to be dobe to the pt in the hospital but you shld probe for this kind of thing, too. Vitals to include b/s? Abt? Admitting Dx? Last BM? A/O? Etc...

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Specializes in Med/Surg, Ortho, ASC.

I am always aghast at questions that indicate that a practicing nurse is making decisions AT WORK while relying on an Internet forum.

Nurses are REQUIRED by their licensure to make decisions based upon their education, experience and their current employer's policies & procedures.

In no way, shape or form should any licensed professional nurse be making patient-care decisions based upon an Internet survey.

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Specializes in Med/Surg, Ortho, ASC.

Oops - duplicate

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Wow, There are some harsh people on this site. No, I did exactly what I was suppose to do contrary to popular belief. My MD question my decision so I though I was joining a site that may could help a fellow nurse. Have a nice day

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To address something mentioned above, I've only ever seen VRE treated once (with Zyvox for VRE in the urine). I've never seen anyone getting ABX for a positive perirectal culture because, as I understand it, the evidence for abx effectiveness is limited.

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Specializes in Med/Surg, Ortho, ASC.
Wow, There are some harsh people on this site. No, I did exactly what I was suppose to do contrary to popular belief. My MD question my decision so I though I was joining a site that may could help a fellow nurse. Have a nice day

Sorry I came across as harsh. I hope you'll admit that your post did appear as if you were asking the forum for clinical advice. Believe it or not, folks do come here and ask total strangers how to care for their patients or what to do in specific situations that are clearly a matter of nursing judgment and policy procedures.

But again, I apologize.

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Specializes in Hospice / Psych / RNAC.

Your post appeared to me that you were asking for back up information from all of us kind, understanding humans. I know you just didn't admit someone and than text this site for protocol advice. You want to know how I know this...because when you took report on this admit that info was given to you, and if it wasn't the doc who signed the admit order would make sure you all were following protocol and with all those people standing around waiting to see what to do with the new admit, well...you would look silly texting us here online. :lol2:

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So, what was the outcome? Was the pt put on isolation?? Just curious, maybe we can use this as a referral?? (ha,ha)

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