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MRSA
Methicillin-resistant staphylococcus aureus
Gram + bacterium Developed resistance to beta-lactam antibiotics Spread through contact with the bacteria S/S depend of location/type of infection Most commonly are skin infections; can lead to sepsis, cellulitis, endocarditis, pneumonia, osteomylitis, or TSS
C. Diff
Clostridium Difficile
Gram + bacterium Most prevalent hospitalacquired infection Strains with reduced susceptibility to both metronidazole & vancomycin are common Mild-mod. diarrhea, pseudomembranous colitis, toxic dilatation of colon, sepsis, and death
VRE
Vancomycin-Resistant Enterococci
Gram + bacteria Have become resistant to Vancomycin Are hardier than MRSA Can remain viable on environmental surfaces for weeks Similar to MRSA - S/S depend on type and location of infection
HANDWASHING!!!
Contact Precautions
Gloves Gown Face mask/Shield PRN
Isolation
Essential!! Decreases transmission to other individuals Private bathroom is key with C. Diff Avoid transporting pt. Assess for adverse affects
Barrier Precautions
Dedicate equipment to the room or disinfect prior to exiting Disposable equipment when possible Dont bring anything into room that you dont have to! Change linens PRN
Antiseptics
Lysol, CaviWipes, Clorox for cleaning equipment Chlorhexidine for VRE Alcohol-based hand sanitizers are ineffective for C. Diff
Pop Quiz!
1. Precautions used for C.Diff, MRSA, and VRE include: (Select all that apply) A. Direct contact B. Indirect contact C. Airborne D. Droplet
Pop Quiz!
Ques. 1 Answer: - A & B. Direct and Indirect Contact precautions
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2. Which of the following is used to clean equipment used with a pt with MRSA infection? A. Clorox and CaviWipes B. Chlorahexidine C. Alcohol-based products
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Ques. 2 Answer: -A. Clorox and CaviWipes
Pop Quiz!
3. According to ACH P&P, what is the most stressed action R/T contact precautions? A. Green sticker outside door B. Hand washing C. Gown and gloves worn
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Ques. 3 Answer: -B. Hand washing
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4. Case Study: 33y/o male pt admitted with active C. Diff. Has had multiple foul-smelling, watery stools. Upon emptying the bedpan the RN should don.. (Select all that apply) A. Gloves B. Gown C. Face shield D. Hair net
Pop Quiz!
Ques. 4 Answer: -A, B, & C. Gloves, Gown, and Face shield
Pop Quiz!
5. Are alcohol-based hand sanitizers effective against C. Diff? True ___ False ___
Pop Quiz!
Ques. 5 Answer: -False. Alcohol-based hand sanitizers are ineffective against C. Diff.
References
Larson, E.L., Cohen, B., Ross, B., & Behta, M. (2010). Isolation Precautions for Methicillian-Resistant Staphylococcus Aureus: Electronics Surveillance to Monitor Adherence. American Journal of Critical Care, 19(1), 16-26. Retrieved from http://ebscohost.com/ Lewis, S.L., Dirksen, S.R., Heitkemper, M.M., Bucher, L., & Camera, I.M. (2011). Medical-Surgical Nursing. Assessment and Management of Clinical Problems: Elsevier Mosby Shenold, Carol. (2011). 9461: Clostridium Difficile: Superbug. Retrieved from http://www.netce.com/coursecontent.php? courseid=769 Siegal, J.D., Rhinehart, E., Jackson, M., et al. The Healthcare Infection Control Practices Advisory Committee (HIPAC). (2006). Management of Multi-Drug Resistant Organisms in Healthcare Settings. Retrieved from http://m.cdc.gov/