July 1, 2013 at 11:52 AM #7592
Jason Hautala RNMember
Are there any infection control nurses here who can actually make me care about MRSA? My state, WA, has mandated by law, that every single ICU patient be swabbed for MRSA and everyone who tests positive has to be reported to the DOH. My hospital policy, in order to comply with this law has also added the care of these patients must be down with gown and gloves.
What a waste of time and money.
I don’t remember the numbers, but a good percentage of the people in my county carry MRSA in their nose. Even though we test for MRSA, we aren’t treating it (Thank God.) I would put good money if they tested the nursing staff in my hospital, a decent number of people would test POS for MRSA. Most of the ER docs don’t even culture wound abscesses anymore because the all come back as MRSA and we treat all abscesses as if they were MRSA and treat accordingly. If they fail treatment or it progresses, then we will culture it, but these cultures are rarely of any clinical value.
Why should I care about MRSA at all … it is just another bug, and not nearly as bad as many of the bugs I see every day. Why should we test people for it when their chief complaint has nothing to do with it, and regardless of the results, it doesn’t change their care, other than to make ICU nurses dress funny, and then the MSP nurses have to dress funny every time that patient is re-admitted to the hospital because now they are on the “MRSA LIST” oh my.
Proper universal precautions is all that is needed for patients with MRSA. All patients should be instructed on proper infection prevention at discharge, and not just those that tested POS for MRSA.
Am I missing something here or did some senator’s family member have a bad outcome because of a MRSA infection and now the entire state has to suffer?July 1, 2013 at 5:54 PM #7641
I can go one better. Our ICU was part of an MRSA study and because of that, every ICU gets an antibiotic ointment swab in each nostril twice a day for 5 days and a daily bath with a special wipe made for MRSA patients. EVERY ICU PATIENT. Anyone that has had a history of MRSA on a swab in their nose in the past is an automatic contact precaution and takes and act of Tennessee Congress, 3 notarized letters by fictional superheroes and one vial of holy water from the pope to be taken off contact precautions….even if the swab is negative this time. OK, slight exaggeration. But truly, if they have been positive in the past and negative now, we can’t take them off and have to do all of this cleaning every day. We were told that during the study, our infection rate dropped 46% so maybe it is worth it.July 1, 2013 at 10:53 PM #7650
Jason Hautala RNMember
Sure … I’ll buy that if you actually bathe your patients daily, infection rates will go down, but these laws are just stupid. WA is the same way (at least my hospital is) in that once you are on the list, it is nearly impossible to come off. I think you need two negative swabs over a year apart or something like that.
Antibiotic ointment up the nose of every ICU patient should be illegal. That is how so many antibiotic resistant bugs came about is because the farmers started giving them to every cow. Expose a population of bacteria to something that kills most of them, only those that are resistant will live long enough to have baby bacteria.
Instead of trying to make the world, and our bodies, sterile, I think it would be a better plan to find some friendly bacteria and just coat ourselves and surroundings with them, so the more passive bacteria can out compete the more aggressive ones. Sure, we will still need antibiotics and bugs will still become resistant, but it would slow the process down if we worked with nature instead of trying to treat everybody. With our current practice, it won’t be long before we have bacteria that are resistant to every antibiotic (I actually had a patient like that once … had to put on a special suit just to go in the room with her …. she died.)
MRSA is not a big problem …. but we will make it one.July 1, 2013 at 11:14 PM #7651
I know this is a serious subject, but some of both of your comments made me laugh.
I see both of your points. It is a delicate balance between cost effectiveness and necessity
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