Prevent the spread to anyone by...

Cover your wound. Keep wounds that are draining, or have pus, covered with clean, dry bandages until healed. Follow your healthcare provider's instructions on proper care of the wound. Keeping the infection covered will help prevent the spread to others. Bandages and tape can be discarded with the regular trash.

Clean your hands. You, your family, and others in close contact should wash their hands frequently with soap and water or use an alcohol-based hand rub, especially after changing the bandage or touching the infected wound.

Do not share personal items. Avoid sharing personal items, such as towels, washcloths, razors, clothing, or uniforms, that may have had contact with the infected wound or bandage. Wash sheets, towels, and clothes that become soiled with water and laundry detergent. Use a dryer to dry clothes completely.

Maintain a clean environment. Establish cleaning procedures for frequently touched surfaces and surfaces that come into direct contact with your skin.

Talk to your doctor. Tell any healthcare providers who treat you that you have or had a staph or MRSA skin infection. There are things that can be done to protect people that carry staph/MRSA from getting an infection or spreading it to others when they are in the hospital or have surgery.

CDC. (2012). Prevent the spread of MRSA if you have it. Retrieved from http://www.cdc.gov/mrsa/prevent/personal.html

Basic Contact Precautions in Health Care Facility

1) Patient placement- Place patients in a private room, if possible. If not, place in a room with someone else who currently has MRSA as well.

2) Gloving- Wear gloves whenever touching the patient's intact skin or surfaces and articles in close proximity to the patient Don gloves upon entry into the room or cubicle.

3) Gowning- Don gown upon entry into the room or cubicle. Remove gown and observe hand hygiene before leaving the patient-care environment. After gown removal, ensure that clothing and skin do not contact potentially contaminated environmental surfaces that could result in possible transfer of microorganism to other patients or environmental surfaces.

4) Patient transport- In acute care hospitals and long-term care and other residential settings, limit transport and movement of patients outside of the room to medically-necessary purposes. When transport or movement in any healthcare setting is necessary, ensure that infected or colonized areas of the patient's body are contained and covered. Remove and dispose of contaminated PPE and perform hand hygiene prior to transporting patients on Contact Precautions. Don clean PPE to handle the patient at the transport destination.

5) Patient-care equipment and instuments/devices- Use disposable noncritical patient-care equipment or implement patient-dedicated use of such equipment. If common use of equipment for multiple patients is unavoidable, clean and disinfect such equipment before use on another patient.  In home care settings limit the amount of non-disposable patient-care equipment brought into the home of patients on Contact Precautions. Whenever possible, leave patient-care equipment in the home until discharge from home care services. If noncritical patient-care equipment cannot remain in the home; clean and disinfect items before taking them from the home using a low- to intermediate-level disinfectant. Alternatively, place contaminated reusable items in a plastic bag for transport.

6) Environmental measures- Ensure that rooms of patients on Contact Precautions are prioritized for frequent cleaning and disinfection (e.g., at least daily) with a focus on frequently-touched surfaces and equipment in the immediate vicinity of the patient.

7) Discontinuation of Contact Precautions

No recommendation can be made regarding when to discontinue Contact Precautions.

CDC. (2012). Precautions to Prevent the Spread of MRSA in Healthcare Settings. Retrieved from http://www.cdc.gov/mrsa/prevent/healthcare/precautions.html

Regulators?

I found a study about healthcare personnel at a nursing home. In the study, they discovered ways to help control MRSA and infection control in the home, if applied. It involved time, financial resources, environment, management, culture, hospital, families, client themselves, and regulation. If they had the financial resources from there management to provide staff, it would create time for the health care workers to take the precautions necessary. They mostly felt rushed. If they also had money, they could provide better cleaning products, but the further up part of management states that quota cannot be met. Patient’s would leave for the hospital and come back with MRSA, CDIFF, or/and UTI. Families would sit on the patient’s bed and touch everything without washing their hands on the way out. If other patient’s go around and touch other patients it spreads. Overall regulation is the main problem. Watching how we care for these patients are important to prevent outbreaks at these facilities but these interventions are needed to do this.

McClean, P., Tunney, M., Parsons, C., Gilpin, D., Baldwin, N., & Hughes, C. (201 2). Infection control and meticillin-resistant Staphylococcus aureus decolonization: the perspective of nursing home staff. Journal Of Hospital Infection, 81(4), 264-269. Retrieved at http://www.sciencedirect.com.ezaccess.libraries.psu.edu/science/article/pii/S019567011200148X

Contact precautions or not

An article was posted about patients being place in contact precautions basically if they were once a carrier or had a history of it at one specific hospital and about the costs of it. It concluded that it was expensive and unnecessary at the facility and they changed the policy for it. 

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Background

Methicillin-resistant Staphylococcus aureus (MRSA) is frequently encountered in health care facilities. Many hospitals have established screening programs to identify individuals harboring the organism. Patients identified as carrying MRSA are frequently placed in Contact Precautions at time of admission.

Methods

Between January 1, 2007, and December 31, 2010, we screened a select group of patients for MRSA employing polymerase chain reaction testing. We recorded our screening results and also recorded the MRSA hospital-acquired infection (HAI) rate. In January 2010, we discontinued placing individuals, asymptomatically colonized with MRSA, in Contact Precautions.

Results

Between January 1, 2007, and December 31, 2010, we screened 6,712 asymptomatic patients for MRSA and found 633 (9.4%) to be positive. During this same time period, we encountered 7 MRSA HAI. There was 1 MRSA HAI in the first year and 2 in each of the last 3 years of the study period. The costs incurred for Contact Precautions for the MRSA study population averaged $8,055 per year for each of the first 3 years and $0 for 2010.

Conclusion

Placing patients who are asymptomatically harboring MRSA in Contact Precautions did not decrease the rate of HAI caused by this organism and was relatively expensive.

Spence, M. R., Dammel, T., & Courser, S. (2012). Contact precautions for methicillin-resistant Staphylococcus aureus colonization: Costly and unnecessary?. American Journal Of Infection Control, 40(6), 535-538. doi:10.1016/j.ajic.2011.07.016

Checking for M.R.S.A

I found this article "MRSA Screening" online at Lab Test Online. It talks about how they test for MRSA in the hospital setting, which is what we are most familiar with.

The most common testing for MRSA is the culture, which takes about 1-2 days. A nasal swab is collected on all admitted patients into the hospital and sent to the lab to be cultured. The test is done by inserting the swab approximately 1 in. into the patient's nostril and swabbing both of the patients nares in a circular motion. When a patient's wound is suspected to having M.R.S.A, we also may swab the patient's wound.

You can find more information on the website at:
http://labtestsonline.org/site/

What is M.R.S.A.

MRSA stands for methicillin-resistantStaphylococcus aureus. MRSA is a “staph” germ that does not get better with the first-line antibiotics that usually cure staph infections.
When this occurs, the germ is “resistant”to the antibiotic.
Most staph germs are spread by skin-to-skin contact (touching). A doctor, nurse, other health care provider, or visitors may have staph germs on their body that can spread to a patient.
Once the staph germ enters the body, it can spread to bones, joints, the blood, or any organ, such as the lungs, heart, or brain.
Serious staph infections are more common in people with a weakened immune system. This includes patients who:

• Are in hospitals and long-term care facilities for a long time
• Are on kidney dialysis (hemodialysis)
• Receive cancer treatment or medicines that weaken their immune system
• Inject illegal drugs.
• Had surgery in the past year

MRSA infections can also occur in healthy people who have not recently been in the hospital. Most of these MRSA infections are on the skin or less commonly lung infections. People who may be at risk are:

• Athletes and other people who may share items such as towels or razors
• Children in day-care
• Members of the military
• People who have gotten tattoos

Draining a skin infection may be the only treatment needed for a skin MRSA infection that has not spread. A health care provider should do this procedure. Do not try to pop open or drain the infection yourself. Keep any sore or wound covered with a clean bandage.
Severe MRSA infections are becoming harder to treat. Your lab test results will tell the doctor which antibiotic will treat your infection. Your doctor will follow guidelines about which antibiotics to use and look at your personal health history. MRSA infections that are harder to treat are ones in:

• Lungs or blood
• People who are already ill or have a weak immune system

You may need to keep taking these antibiotics for a long time, even after you leave the hospital.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004520/

Use of copper alloys

I found an interesting article on controlling M.R.S.A. in the workplace. It found that the use of copper alloys are being tested to determine if it will less cross contamination and lower rates of infection.  McAurley (2009) wrote

“The first results from a clinical trial in Birmingham, England, demonstrate that the use of copper on certain surfaces on a busy hospital ward resulted in 90-100 percent fewer micro-organisms than the amount found on the control ward. The EPA registration was granted based on independent laboratory tests demonstrating that copper, brass and bronze are more than 99.9 percent effective in killing specific disease-causing bacteria, including Methicillin-resistant Staphylococcus aureus.”

McAuley, D. (2009, January 6). International copper industry defines role in the fight against hospital infections. Medical News Today. Retrieved from

http://www.medicalnewstoday.com/releases/134436.php.