With every single shift that I work; there is at least one patient that is on something called contact isolation precautions for MRSA (methicillin-resistant staphylococcus aureus). What is that and why is that necessary, you ask?
Because antibiotics were overprescribed for years, organisms developed that are resistant to the antibiotics that used to work on them. This is why your doctor tells you to make sure you take all of your antibiotics, as prescribed, and not to stop taking them even if you feel better.
Here is an awesome generalized explanation of super bugs and how they came to be. It’s about 10 minutes, but it’s so good and worth your nursey time!
This presents quite a problem when a patient shows up to the hospital and the antibiotic of choice for their infection won’t work because they’re resistant to it. Therefore, we need to do as much as possible to prevent the spread of these resistant strains!
Today, most patients are screened for MRSA when admitted to the hospital so that we know who has this specific resistant strain. We don’t want to spread this multi-drug resistant organism from patient to patient as we care for them throughout the day and night.
Keep in mind, there is a difference between an active MRSA infection and a MRSA colonization.
An active MRSA infection means someone has gotten sick because of this bacteria. And you, as the nurse, would know this because it would be part of their admitting diagnosis.
A colonization means that the person is healthy, but carries the bacteria and it can be spread to others.
So when you swab your patient’s nose, send it down to the lab, and 1 hr later they call and say, “Ummm.. yea Mr. Smith in room 872 is MRSA positive,” that means that they have a colonization of MRSA, not an active infection. Then you have to go put them on contact precautions so they don’t spread this resistant organism to other patients.
Not only can this can be kind of hard to understand as a new nurse, but it is also difficult to explain to the patient and their family as well. This is my basic explanation to someone that comes in and screens positive, and we therefore have to put them on contact isolation precautions.
“Do you remember when we swabbed you when you came in? Well, what we were testing you for came back positive. What we tested you for was something called MRSA. It’s not an infection; it’s an organism that is resistant to some antibiotics. This is important for us to know to insure you get the appropriate antibiotics, if they’re needed, and so that we are not passing along this resistant organism to other patients. So, whenever staff members come in, they’re going to be wearing gowns and gloves to protect themselves from passing this along to the other patients that we’re caring for.”
Most hospitals have written patient education that you are required to discuss with them, so make sure you’re following your hospital’s policies and procedures on what to do when someone comes back with a positive MRSA screening. It has answers to the typical questions (“where did I get this,” “how is it spread,” “will you give me more antibiotics to treat it,” etc.). And it’s good to give them something written that they can refer to later.
I also tell the family that’s in the room that we’d like them to wear and gown and glove when they’re in the room and make sure they wash their hands. It’s important not to spread it to one another so everyone isn’t acquiring MRSA. Make sure you document your face off when you do your job by educating your patient and family!
Some of you may have had patients get CRE (carbapenem-resistant Enterobacteriaceae), a new and terrifying resistant organism. Here’s a great video explaining this craaazzzy super bug! I also like that he looks like he’s about to sneeze. The perfect screen shot.