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Old 06-28-2007, 12:18 PM
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Question What do you do for MRSA in your hospital?

I can't find the article now, but read one this week saying that the incidence of MRSA is higher than originally thought.

Of course, anyone who comes in with prior history of MRSA is immediately isolated... but our ICU also swabs every patient's nares on admission. It isn't a hospital-wide practice, but it may come to that.

Most nursing home patients end up coming back positive, but I've been surprised by a few random patients who somehow acquired it in the community coming up positive as well.

All we do, though, is isolate these patients, we don't even treat them with mupirocin. Hmm... something to ask about.

So... does anyone else check some/all admissions for MRSA? Does anyone else treat preventively? At another hospital I worked at, EVERY single open heart patient got mupirocin ointment in their nares whether they tested positive or not.

And how do you say it anyway? One hospital got me saying "Mersa" and the one I'm at now spells it out "M-R-S-A." I'd rather just say "mersa," but then people don't know what I'm talking about.
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Old 06-28-2007, 01:07 PM
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I'm not sure what our hospital does about MRSA. It seems that I've heard the medical/surg nurses say that patients go into isolation, but that it's far from being a strict type of isolation.
I think our hospital is weak when it comes to infection control.
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Old 06-29-2007, 03:21 PM
GuitarGirlRN
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Default isolation? HA!

I work in the ED--we don't swab, we barely isolate. This has me worried!

My colleagues and I all joke that we have MRSA (we say "mersa") of the nares from just working here.
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Old 06-29-2007, 11:49 PM
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all i can say is that the acute care facility we're having clinical at just posts a yellow "contamination warning" outside the patients' door. that's all. oh, and they have them wear a mask if they leave their room for pt or something. doesn't seem very strict nor very isolate.
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Old 06-30-2007, 03:01 AM
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MRSA has become a massive political issue in the UK, people are obsessed with it. It has come to mean that your hospital is dirty rather than your local population has previously been over prescribed with antibiotics. Millions must now be spent in swabbing everything that moves, isolating people and in checking people are complying. There is this idea that MRSA is a UK problem, when actually I suspect as has been mentioned above, that perhaps we are just looking for it more.
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Old 06-30-2007, 03:02 PM
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Default We isolate

I work in a mainly open baby PICU (pediatric intensive care unit) and we put them on precautions (gown, glove, mask) and then keep everyone like 4 feet from their bed or something.

In the winter pretty much everyone gets cultured for H. flu, RSV, and MRSA. In the summer only if a wound is infected, or something has a rare summer resp infection do we culture. And of course all septic patients get cutlured for everything under the sun.

I respond to both M.R.S.A and mersa. I personally use M.R.S.A. though.
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Old 06-30-2007, 10:15 PM
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We isolate everyone who comes back positive. Gown, gloves and if it's in sputum, a mask too.

If family members are in there, they don't have to gown and glove up, unless they're helping provide care. The rationale is that they aren't going from patient room to patient room.

It seems like we isolate a lot more patients than ever. Isolation is such a PITA!!!
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Old 07-03-2007, 09:16 PM
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Post Mrsa

Community acquired MRSA is on the rise. I've known a few "healthy" people who work in health care who have wounds that have tested positive for MRSA. I have seen young adults come into the ER with staph infections that have been MRSA positive.

Most nursing home patients have at the minimum a history of MRSA. If it's a MRSA wound that is healed and no longer open, we don't isolate. If the MRSA was in the sputum, we still isolate until they have 3 cultures that come back negative. Our face sheets when a patient is registered for care tell us if the patient has a history of TB, MRSA, or VRE; at least we get a little bit of a head's up when it comes to that.

Guitar Girl, I smirked when you said that you all joke about having MRSA in your nares if you work the ER. I'm afraid the real joke is on us, we probably really do.
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Old 07-04-2007, 03:39 PM
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I remember seeing so many "spider bites" last summer that I thought they had mutated and were consuming the human race. Except that these were not "spider bites", they were MRSA wounds and it is rampant in the community. We're talking all ages - teens to elderly.

In the last ER I worked in, all nursing home patients were given private rooms, everything you could culture was cultured and they were isolated until proven negative.

Currently in the ER, we just use universal precautions for everyone , but not masks. I'm probably a walking MRSA microbe.
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Last edited by KimRN; 07-04-2007 at 03:40 PM. Reason: Typographical boo boo
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Old 07-05-2007, 04:34 PM
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In our unit/hospital, all of our open heart pt's use muprocin to the nares BID, x7 days post-op. If they are a scheduled heart, they are prescribed muprocin to be used pre-op, though I am not sure how many days/times prior to coming in.

As far as screening for MRSA goes, we don't unless we get a positive C&S. (Perhaps this is a "If we don't know, we don't have to treat it stance." I hadn't really thought about it before.)

For our MRSA/VRE/C-Diff pt's we are required to glove & gown if we are coming into contact w/ anything the pt may have touched. If we are just going in to write down vitals, check respirations, etc. and are not going to actually touch the pt, we are not required to wear personal protective equipment.

Also, in case you aren't aware of this, using alcohol foam or gel for pt's w/ C-Diff is an ineffective form of disinfection. This is because the C-Diff toxin is a spore. Always WASH YOUR HANDS with these pt's. We actually post a sign over the alcohol foam dispenser to remind RNs, physicians, and families to not use it.
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