Jc Risk Assessment Paper

Xander L. is a 17-year-old African American male and documented gang member. His prior juvenile adjudications include purse snatching, breaking and entering, and drug possession. His first juvenile adjudication occurred when he was 13 years old. He has served a year of custody in the juvenile correctional facility and has been placed on probation twice

The increasing incidences of MRSA in the hospitalized patients are becoming an alarming problem due to the poor surveillance screening for risk of infection. The literature and synthesis of the evidence largely recommends that the use of universal MRSA surveillance can increase the identification of MRSA infection or carriage. Likewise, evidence suggest that the use of universal surveillance combined with the implementation of isolation precautions and other infection control measures will result to improved patient outcome (Guleri et al., 2011).

The proposed evidence-based practice change is to reduce the incidence of hospital-acquired infections (HAIs) and/or multi-drug resistant organisms (MDROs) through the daily use of chlorhexidine-impregnated wipes or chlorhexidine soap among patients in the intensive care unit (ICU) and medical-surgical units. Chlorhexidine gluconate is a broad-spectrum, antiseptic agent against several pathogens, such as S. aureus and enterococcus species (Climo et al., 2013, p. 534). Daily baths will be emphasized to patients with the current diagnosis of a HAIs, MDROs or are currently and/or have chronic suppressed immune systems. Furthermore, providing education to staff and patients and their families regarding the prevention of HAIs and MDROs through the use of chlorhexidine bath products will help implement this EBP change.

According to the Centers for Disease Control and Prevention [CDC] (2016) "MRSA can cause severe problems such as bloodstream infections, pneumonia and surgical site infections. If not treated quickly, MRSA infections can cause sepsis and death” (para. 1). Elderly and individuals with depleted immunity (Mayo Clinic, 2016), patients in intensive care units (ICUs) where the antibiotic resistance and antibiotic use are the highest (Ma et al., 2015, p. 1), nursing home (NH) residents, and patients with indwelling devices are the most vulnerable population for the MRSA infection (Mayo Clinic, 2016). MRSA infections can put financial and physical strains to the healthcare system as observed by Hanna (2011), “MRSA costs the US healthcare system up to $34 billion a year and accounts for over 8 million additional hospital

MRSA is no longer solely transmitted throughout the health care setting, it is within the community. The risk factors of MRSA within the health care setting is being hospitalized because patient are more vulnerable, having an invasive medical device implanted because it allows MRSA easier access into the body and staying in a long-term care facility because even carriers of MRSA may spread the disease(Methicillin Resistant Staphyloccus aureus (MRSA), 2016). The risk factors within the community is partaking in contact activities because of the skin to skin contact and the cuts and abrasion which MRSA can get into and living in a crowded area or unsanitary conditions because MRSA can easily be spread (Methicillin Resistant Staphyloccus aureus (MRSA),

“Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of preventable nosocomial infections and is endemic in hospitals worldwide” (Sadsad, Sintchenko, McDonnell, Gilbert, p.1, 2013). MRSA is a bacterial infection that is resistant to antibiotics that are usually used to treat staphylococcus infections. MRSA is mostly found on the skin, but can also be seen in wound or sputum. Nurses and other healthcare workers can help prevent the spread of MRSA by maintaining a good hand washing hygiene, putting patients in isolated rooms. However, patients with a history of MRSA should have an indicator on the door to inform staff of the infection. Nurses and other staff that will have physical contact with patients should be meticulous about using standard precautions, such as wearing protective equipment like gowns and gloves when handling patients with

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.

In a study Herrmann, Petit, Dawson, Biechele, Halfmann, von Müller ... and Gärtner (2013) conducted a widespread screening in the admission of patients to hospitals for methicillin resistant Staphylococcus aureus (MRSA). The purpose of this study is to show that to help control the spread of MRSA in hospital by having admission prevalence screenings. MRSA is a major nosocomial infection in hospitals and has become a problem that can be hard to manage in patient safety. There are certain risk factors that a patient can possess when they become infected with MRSA or are positive carriers. So, if there can be a prevalence screening for these risk factors upon admission hospitals would be able to tell if the MRSA was acquired while in the hospital or if the patient was already infected. In the other case studies discussed they examine steps that can be taken in the case of MRSA already infecting patients and then treating, isolating, and preventing from infecting many more. The study administered by Herrmann et al. examines patients upon admission meaning this could help reduce the spread of MRSA other than finding that it infected patients already admitted.

Infectious diseases are quickly becoming one of the leading causes of death in the United States and the world (Morens, 2013). They threaten immunocompromised individuals and are able to cause severe illness in otherwise healthy people. Hospitals and communities have developed protocols in an attempt to prevent further pathogen transmission. One infectious agent that has been at the apex of medical research is Staphylococcus aureus, which is a Gram-positive coccus. This microorganism colonizes the skin, respiratory tract, and nasal passage in about

SHEA released an updated guideline on SSI prevention that includes several recommendations not found on CHOG’s policy. The first recommended intervention is to screen and identify all surgical patients who are S. aureus nasal carriers. According to Barnard (2002), studies have shown that most SSIs are caused by the patient’s endogenous infection (own bacterial flora) of which, 20% is caused by S. aureus strain. According to Van Rijen, Bode, Baak, Kluytmans, and Vos (2012), about 20-50% of the population are S. aureus nasal carriers. Moreover, Van Rijen et al. (2012) adds that S. aureus nasal carriage is now considered a predisposing factor for future infections in different patient populations (i.e. dialysis patients, patients with intravascular devices, surgical patients, and patients who are admitted to the intensive care unit [ICU]).

The rate of MRSA infection and colonization is in a steady increase since its emergence in 1961. Though the number of MRSA may decrease but the vulnerability of infections such as invasive diseases are still in the news (Eili Y. Klein 2017). Furthermore, the MRSA infections are getting more limelight as treatment of these infections are also problematic because of emergence of resistance to available drugs (18).

from 2006 to 2007 showed that that the percentage of SSIs caused by S. aureus increased to 30%, with MRSA accounting 49.2% of these isolates [61]. with higher mortality rates, longer hospital stays, and higher hospital costs compared with other infections]. were associated

The effects of this in healthcare can be seen in the infamous MRSA – Methicillin resistant staphylococcus aureus which is not just

Low adherence to appropriate antimicrobial prophylaxis is contributed by lack of established guidelines hence resulting in high rate of broad spectrum antibiotic use, long duration and inappropriate timing of first dose(Bank, 2014)

The average results between four hospital wards showed that the highest frequency of mecA positive isolates were screened from hospital SWs (26%) and ICUs (22%) followed by hospital IMs (18%) and OTs (11%), respectively (Fig. 4). Frequency of mecA positive isolates in all sampling wards of hospital1 was higher than other hospitals and hospital wards. The frequencies of airborne MRSA isolates obtained from various wards showed that the ICU of hospital1 had the highest occurrences of airborne MRSA (49%) and therefore patients are vulnerable to serious infection with MRSA in this part of a hospital. This Hospital is the biggest, busiest and most crowded teaching hospital among these hospitals studied. ICU of this hospital contains of 32 beds that are almost always fully occupied. Previous studies concluded that overcrowding, mix of patients and nurses, understaffing contributed significantly to the dissemination of MRSA in ICUs (Spread of methicillin-resistant, Nursing staff workload as). Sexton et al, in a study of the environment of the isolation rooms of MRSA patients reported that the relationship between the number of patients in a relatively small confined space and the possibility of increased colonization or infection ().They reported that about 25% of air samples and over half of the surface samples were positive (). On the other hand, higher levels of MRSA contamination in