Mrs. Jackson is a frail elderly woman who presents to the Emergency Department with a fall and an injured hip. During her assessment, the local hospital’s policy of screening for methicillin-resistant Staphylococcus aureus (MRSA) is initiated. In addition to confirming a hip fracture, Mrs. Jackson is now “flagged” as a MRSA carrier. Her hospital’s isolation and contact precaution protocols are swiftly implemented. Along her journey to fix her hip, Mrs. Jackson experiences delays in getting a hospital bed, receives less attention from her healthcare team, and feels emotional distress as a consequence of this MRSA label.
The use of patient isolation and contact precautions for MRSA is a controversial issue resulting from evidence that both
…show more content…
The Center for Disease Control and Prevention (Siegel, Rhinehart, Jackson, & Chiarello, 2017) and the Association for Professionals in Infection Control (Aureden et al., 2010) recommend contact precautions for the prevention of MRSA transmission. Contact precautions include isolating the patient in a private room (or placing physical barriers between patients) and the mandatory use of gowns, masks, and gloves during patient interactions (Siegel, Rhinehart, Jackson, & Chiarello, 2017; Ofner-Agostini et al., 2007).
Are Contact Precautions Effective?
The research on the actual effectiveness of contact precautions for preventing MRSA transmission is controversial. There are studies that demonstrate a reduction in MRSA transmission and infection rates after implementation of contact precautions (Kypraios, O’Neill, Huang, Rifas-Shiman, & Cooper, 2010; Landelle, Pagani, & Harbarth, 2013; Marshall, Richards, & McBryde, 2013). However, there are newer conflicting studies that show the discontinuation of contact precautions does not increase transmission or infectivity rates of MRSA (Bardossy et al., 2017; Martin et al., 2016; Mckinnell et al., 2017; Renaudin et al., 2017). A Cochrane review of contact precautions in the hospital setting concluded that “there is no scientific evidence that the wearing of gloves, a gown, or a
There are several important steps in preventing the spread of MRSA: washing hands before and after patient contact, using gloves appropriately, covering any cuts on the hands, maintaining healthy hands, avoiding overcrowding in hospital departments, maintaining a clean environment, and prudent antibiotic prescribing (3). Hand washing is the most effective way to keep from spreading infections. The CDC recommends that you spend 20 seconds scrubbing your hands with soap while washing your hands (1). You can sing the “Happy Birthday” song twice all the way through also (1). If soap and water are not available, the CDC recommends using an alcohol-based hand sanitizer that is at least 60% alcohol (1). This should not be used as a first line of defense. Hand washing is always the best way to get rid of harmful bacterium. Gloves and gowns are another great way to create a barrier between you and the bacteria. Proper removal of gloves and gown are vitally important. If your gloves are contaminated with MRSA, and you remove them improperly, you have completely defeated the point of even putting the gloves on. Once a surface is contaminated with MRSA, it can live prolonged periods of time unless removed through cleaning (5). For contaminated surfaces, you would want to use a disinfectant. Choosing the proper disinfectant, along with following the directions of use on the packaging, will rid the surface form microbes. It is extremely important to follow the directions on the packaging of the disinfectant because each disinfectant is different. One may need you to keep the surface wet for 2 minutes, while the other requires the surface to be kept wet for 10 minutes. If the surface isn’t kept wet for the allotted time, the surface will not be disinfected and will continue to contaminate
A course of action that could be taken is during wound dressing and changes the nurses should gown up (Masks, gloves, and gowns) to prevent any further infections with MRSA with this patient. According to Lopez and associates this could benefit the patient by keeping the chance of transmission at minimum. Another aspect that could have been done as stated by Gurusamy and associates is the use of antibiotic prophylaxis. By doing this it will help prevent MRSA from contaminating and entering the patients wound.
Touching objects, such as public phones or doorknobs, that have MRSA bacteria on the surface.
Methicillin-resistant Staphylococcus aureus, or more commonly, MRSA, is an emerging infectious disease affecting many people worldwide. MRSA, in particular, is a very interesting disease because although many people can be carriers of it, it generally only affects those with a depressed immune system; this is why it is so prevalent in places like nursing homes and hospitals. It can be spread though surgeries, artificial joints, tubing, and skin-to-skin contact. Although there is not one specific treatment of this disease, there are ways to test what antibiotics work best and sometimes antibiotics aren’t even necessary.
Health care providers and visitors are required to wear personal protective equipment (PPE) and follow strict hand hygiene procedures. Contaminated rooms, surfaces, and laundry items are properly disinfected to prevent the spread of MRSA. In addition to policy and procedures, patient teaching is also helpful for preventing exposure and spread of MRSA. As aforementioned earlier, hand hygiene is key to prevent exposer or transmission of the bacteria. To properly wash your hand effectively, first scrub hands rapidly for at least 15 seconds. Next, use a disposable towel to dry them and another towel to turn off the faucet. In addition, hand sanitizer that contains 62 percent or more of alcohol may be an adequate substitute when the individual does not have access to soap and water (Mayo Clinic Staff,
Preventable infections regardless of the causative agent, have become major triggers of unintended patient outcome, increased morbidity, and mortality (Arias, 2010). Methicillin Sensitive Staphylococcus Aureus (MSSA) and Methicillin Resistant Staphylococcus Aureus (MRSA) are the most common causes of healthcare associated infections (HAI) and outbreaks in acute care hospitals and community settings (CADTH, 2010). The widespread infection with the MRSA pathogen is believed to have increased from 2.4 percent in 1975 to 29 percent in 1991 and 2003 in hospitals across the United States (U S) (CADTH, 2010). The prevalence is even greater among Intensive Care Unit (ICU) patients at 53 percent (CADTH, 2010) and continues to rise due to the widespread
Residents who are infected with MRSA, or similar superbug are treated with standard contact precautions while being given their medications.These include:
Hand hygiene has been stated as the one main element that can prevent the spread of MRSA (Gould 2002). Washing hands is not kid’s stuff – not in the era of MRSA. Once entrenched MRSA can be extremely difficult to treat. If it gets into the blood stream it can be lethal (Belkum, Verbrugh 2001). Simor and Andrew (2001) also emphasise that hand washing is the most important control practice. It is essential because personal contact is the primary mode of MRSA transmission. Therefore good hand washing technique is vital to ensure that the decontamination is effective, as no soap will be effective if the technique is poor.
Historically MRSA infections have been confined to hospitals and infected those that generally were very sick to begin with. In recent years, MRSA has started to become prevalent in healthy individuals; specifically those on high school and collegiate sports teams. Studies have shown that the rates among athletes tend to be higher in contact sports like football and wrestling (Buss, 2014). The rates also seem to be higher than in the past due to the lack of policy regarding the infections and lack of people following through on the policies in place (Fritz, 2012). MRSA can be prevented for student athletes, especially if those around them are committed to doing what they can to protect the health of the students.
Carla, your post on community acquired MRSA infection, detection, and treatment of the condition is spot on. We all walk around with a variety of bacteria on our skin, especially healthcare workers. As healthcare professionals we are in constant contact with patients with various skin conditions including MRSA so it important to follow guidelines set by our institutions to limit the exposure to ourself and other patients. In addition, to the demographic that you mention in your post at risk for acquiring MRSA, younger non-exposed hospitalized patients are at risk as well.
Both health care-associated and community-associated strains of MRSA still respond to certain antibiotics. In some cases, antibiotics may not be necessary. For example, doctors may drain a superficial abscess caused by MRSA rather than treat the infection with drugs. In the hospital, people who are infected or colonized with MRSA often are placed in contact precautions as a measure to prevent the spread of MRSA. Visitors and health care workers caring for people in isolation may be required to wear protective garments and must follow strict hand hygiene procedures. Contaminated surfaces and laundry items should be properly disinfected. Preventing MRSA includes careful hand washing remains your best defense against germs. Carry a small bottle of hand sanitizer containing at least 62 percent alcohol for times when you don't have access to soap and water. Keep cuts and abrasions clean and covered with sterile, dry bandages until they heal. The pus from infected sores may contain MRSA, and keeping wounds covered will help prevent the bacteria from spreading. Avoid sharing personal items such as towels, sheets, razors, clothing and athletic
When the physician or other healthcare goes into the room they wear certain protective gear. To prevent the spread of MRSA amongst children’s sports it is best advisable to properly cover and dress any cuts and or scrapes. To prevent the spread of MRSA within child day care it is best cover and any wounds that happen during the day care and to teach students proper hand washing techniques. I agree with the preventative measures each facility takes to prepare themselves against a person with MRSA and to prevent the disease. It is very common to contract the disease while working in a healthcare environment so I agree with isolating the patient and use the proper protective equipment each time a worker goes into the patient’s room.
As nurses, taking care of patients with MRSA can be seen in everyday practice. It can be seen in patients with sepsis from an infected wound, patients who have pneumonia, or patients who only have a colonization for it (“Methicillin-resistant Staphylococcus aureus (MRSA), 2015”). Regardless if it’s colonization or an active infection, and the source of the infection, proper policies and procedures are in place to reduce the transmission of MRSA to other patients in the hospital or nursing home setting. This includes performing proper hand hygiene and standard precautions, as well as wearing protective gown and gloves when entering the patient’s room. It is very important to adhere to these policies and procedures and educate others on the importance of these policies and procedures to reduce the transmission of MRSA to others.
Infection control is very important in the health care profession. Health care professionals, who do not practice proper infection control, allow themselves to become susceptible to a number of infections. Among the most dreaded of these infections are: hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). Another infection which has more recently increased in prevalence is methicillin-resistant Staphylococcus aureus (MRSA). These infections are all treated differently. Each infection has its own symptoms, classifications, and incubation periods. These infections are transmitted in very similar fashions, but they do not all target the same population.
). This kind of transmission has been a major factor accounting for the rise in the incidence and prevalence of MRSA in acute care facilities (8). Barrier precautions are often included in recommending control measures for MRSA. For example, contact isolation in a single room has been recommended by the Centers for Disease Control (CDC) and prevention since 1983 for patients colonized or infected with MRSA