Mrsa Precautions

Taking necessary MRSA precautions in any healthcare setting is important to minimize its spread among patients. Washing the hands and wearing of gloves are some of the first essential precautions a person can take to exercise personal care against transmission of MRSA.

MRSA (Methicillin-Resistant Staphylococcus Aureus) is a highly contagious bacterium found on the skin—particularly around the nose area of many healthy individuals. MRSA can become fatal and life-threatening if it gains access to deep tissues, such as open skin cuts which may result in a more severe wound infection, bloodstream infection, and lung problems among other health complications.

MRSA precautions include intensive handwashing and wearing of gloves. Others include changing dressings or bandages, cleaning laundry, and overcoming house-cleaning concerns.

Below are some other necessary precautions a person can take to reduce the spread of MRSA among patients in a healthcare setting:

Standard precautions:

The chief principle behind standard precautions is to treat all patient as if they are infected or colonized. Healthcare staff should exercise some or all of the precaution measures indicated below to protect themselves, patients, and other people in any healthcare setting. These include hand hygiene and PPE (personal protective equipment), including gowns, gloves, nose, mouth, eye protection and taking care of patient care medical devices and equipment, and careful handling of contaminated linen.

Hand hygiene

A person should wash hands after touching another person's bodily fluids, blood, excretions, secretions, and contaminated items, whether or not gloves are worn. Therefore, it's important to perform hand hygiene immediately after removing gloves, contact with patients, and when otherwise indicated to avoid the spread of germs to other patients and the environment. When hands are covered with bodily fluids or blood, a person should thoroughly wash hands with soap and water. It may also be essential to observe hand hygiene between tasks and operations on the same individual, for fears of causing cross-contamination to different body parts during the procedure.

Gloving

A person should wear gloves when they've come in direct contact with another patient's blood, bodily fluids, and other contaminated items. A person should also make sure to remove gloves after coming into contact with a patient and the surrounding environment, using proper technique to prevent hands from being exposed to pathogens. A person should not wear the same pair of gloves for use on more than one patient, and should not clean them for the purpose of reuse to stop transmission of harmful micro-organisms.

Eye, nose, and mouth protection

Healthcare personnel should use PPE to protect the mucous membranes of the nose, eyes, and mouth during procedures. They should also exercise other essential patient-care activities deemed to cause sprays or splashes of bodily fluids, blood, excretions, and secretions. Healthcare staff should also consider using goggles, masks, face shields and other different gadgets depending on the task being performed.

Gowning

A person should wear a gown that's appropriate to the task to protect skin and prevent contamination of clothes during procedures. Nevertheless, patient-care activities should also be exercised in case a person comes in direct contact with bodily fluids, blood, excretions, and secretions of another patient.

Appropriate device handling of patient-care equipment and instruments/gadgets

A person should handle used patient-care equipment covered with bodily fluids, blood, excretions, and secretions in such a way that protects the patient's skin from mucous membrane exposures, contaminated clothing, and other harmful micro-organisms. Nevertheless, every single-use item should be properly discarded and items in close proximity to the patient (bed rails, door knobs, over bed tables, etc) should be cleaned and disinfected to prevent the spread of germs.

Appropriate handling of laundry

Healthcare staff should handle, transport, and process every item of used linen to avoid contamination of surroundings, air, surfaces, and persons.

Contact Precautions:

CDC recommends contact precautions when any healthcare facility (based on local or national regulation) deems MRSA to be of special epidemiologic and clinical significance. The same precautions may be adapted for use in non-hospital healthcare facilities, particularly when a patient has difficulty controlling bodily fluids or draining wounds.

Patient placement

In a patient's placement in hospitals and other settings, healthcare staff should assign the rooms available to patients with suspected or known MRSA infection or colonization. Top priority should be given to patients with acute conditions that may otherwise potentially heighten transmission. In case single-patient rooms are not available, healthcare personnel should cohort patients with the same MRSA in the same room. If this seems impossible, patients with MRSA should be combined with other patients at low risk of contracting MRSA. Nevertheless, it's best to place patients who need contact precautions in a single-patient room at all times.

Gloving

A person should wear gloves before touching a patient's skin, surfaces and other items that might be near the patient (bed rails, medical equipment, etc).

Gowning

Healthcare personnel should don gowns upon entry into the patient's cubicle or room. One is only allowed to undress from a gown and clean hands before leaving the patient-care setting. After gown removal, a person should ensure the skin and clothing do not come in direct contact with potentially contaminated environmental surfaces that could otherwise heighten the spread of germs to environmental surfaces and other patients.

Patient transport

In long-term care and intensive care hospitals and other residential settings, a person should limit movement and transport of patients from their respective rooms unless for medically necessary purposes. However, if a patient's movement or transport in any healthcare facility is required, hospital staff should ensure colonized or infected areas of the patient's body are contained and covered. Afterward, a person should remove and dispose of contaminated PPE and wash hands before transporting patients on contact precautions. Otherwise, don clean PPE to take care of the patient at the transport destination.

Patient-care equipment and instrument/gadgets

Healthcare staff should use disposable non-critical patient-care equipment (e.g. blood pressure cuffs) or provide a patient dedicated access to such equipment. If multiple patients will be using the same equipment, the machine should be thoroughly cleaned and disinfected before use on another patient.

Group activities

It's important to ensure that all patients regularly socialize together and have access to rehabilitation programs around. Therefore, infected or colonized patients should be allowed to join different group activities if bodily fluids are contained, wounds are covered, and every patient exercises good hygiene habits.

Exercising the above MRSA precautions should control the spread of this fatal bacterium in the majority of cases. The goal of these control measures should be to improve patient care, minimize patient mortality and morbidity, and also help reduce healthcare overheads.