MRSA, methicillin-resistant staphylococcus aureus, infected 1.5 percent of the population of the United States in 2004, the Centers for Disease Control and Prevention reported. Hospital-acquired MRSA accounted for around 86 percent of serious infections in 2005, the CDC adds. Preventing and containing MRSA outbreaks is an important part of hospital nursing today.
Nurse Colonization
Although nasal colonization with MRSA occurs frequently in nurses, the bacteria usually remains on the skin only a short time. Nurses with chronic skins lesions are most likely to become permanently colonized with MRSA, the Royal College of Nursing reports. MRSA usually responds quickly to treatment in otherwise healthy individuals, and the treatment should be carried out as soon as colonization is diagnosed, to prevent infection of susceptible patients and other healthcare personnel.
Transmission
Transmission of MRSA is through personal contact or contact with contaminated objects. Nurses can transmit MRSA from one patient to another not only by not washing their hands between patients but also by using the same equipment, such as blood pressure cuffs, on different patients.
Symptoms
Awareness of the symptoms of MRSA helps nurses alert physicians to the possibility of infection in patients. MRSA often appears first as a small red bump that resembles a pimple or boil. The infection can spread inward, causing pockets of infection that require surgical drainage. MRSA can also spread to other organs through the bloodstream, causing life-threatening infection. Healthy people colonized with MRSA often have no symptoms.
Hand Decontamination
Thorough proper hand decontamination is the most effective way to prevent transmission of MRSA between nursing staff and patients. However, studies show that only between 30 and 57 percent of staff actually comply with hand-washing regulations, Marty Vissher, Ph.D and director of the Skin Sciences Institute at the Children's Hospital of Cincinnati reported in the May 2009 issue of "Managing Infection Control." Frequent hand washing can also irritate the skin, causing small breaks that actually increase the risk of MRSA transmission.
Alcohol-based hand rubs increase hand-washing compliance because they're easy to use and easier on the skin if they contain hydrating ingredients. Compliance increased from 48 percent to 64 percent in one Geneva teaching hospital over a three-year period, Vissher states. Placing hand rub solutions at easily accessible spots, such as just outside each patient's room, increases compliance.
Other Preventative Measures
To decrease the risk of MRSA transmission, nursing staff should also keep their nails cut short and not wear artificial nails. Jewelry, especially rings with ridges or stones and watches should also not be worn. Long sleeves should be rolled up when working with patients. Cuts or openings on the skin should be covered with waterproof dressings.
Thorough cleaning of patient rooms and equipment also helps prevent cross contamination. A study of healthcare workers' hands after touching bedside rails and tables showed that 53 percent had MRSA on their hands in patient-occupied rooms. More significantly, 24 percent still picked up MRSA on their hands in rooms that had been cleaned after patient discharge, John Boyd M.D. of Yale University School of Medicine reported.
References
- Centers for Disease Control and Prevention: FAQs About MRSA
- Centers for Disease Control and Prevention: MRSA Infection
- Royal College of Nursing: Methcillin-Resistant Staphylococcus Aureus
- Yale University School of Medicine: Hand Hygiene: An Important Element in Controlling MRSA
- Managing Infection Control: Overcoming Barriers to Hand Hygiene Compliance
