Re: MRSA

[Guest guest]

Here is the deal with MRSA...It can be deadly in certain people (not

to scare you Debra) there is no true " cure " for it It is also a germ

that most of us carry (inactive MRSA cultures test very low) but it

usually does not over populate (active MRSA infection) and most of us

are never tested for it - There are a couple other infections like

this (of course I cant remeber the names) basically they are

antibiotic resistent infections, again some people handle them just

fine other have a problem with them ..Chances are REALLY REALLY good

that if one of your childern tested positive for it every one in your

house would to if they tested every inch of all your bodies (inside

and out)Bottom line is this once a hospital starts having patients

test positve for MRSA they will always have patients test positve for

it ..There really is no getting rid of it ..SO my advise to you would

be relax and and relize that the more often your child goes to the

hospital and to just plain doctors offices the more likely they are

you to test positve for these things ....And enjoy the " special

treatment " at the hospital ..Private rooms, no waiting to be seen

ECTECT...I know this stuff because not only did I have a trach kid

but my mom is a nurse in a nursing home ...VERY common in nursing

homes... Hope this helps mom to CHARGEr 9/30/01-8/3/03 and

3/27/03

-- In CHARGE , " slcharger " <slcharger@y...> wrote:

> Hi grew out MRSA when he was 1 1/2 or 2 years old.

> MRSA is methacillin resistant staph aureuos sorry about the

> spelling. It is a contact multipule resistant organism. I was to;d

> by the infectious disesses staff that once a person is MRSA

> positive they will always be considered " dirty " and always be

> isolated. It does have distinct advantages. Some being we don't

> have to wait in the waiting rooms whether it be ER surgery what

> ever. When is hospitalized he has his own room and

> has one on one nursing care. The pain is being the last patient

> of the day everywhere dr appts surgerys etc. As far as home we

> have never worn masks or gowns we don't even wear them at

> the hospital. No one elae in the family has been diagnosed with

> it. This has been our experience with MRSA

> a mom to 6yr CHARGEr & Quintin 4 yr

[Guest guest]

Mr. Huffman,

Good posting and interesting inquiry. You bring up a legitimate issue

and very often patients are discharged from the hospital prior to having

the " 2 negative tests " completed. Therefore, you have no assurance that

they are colonized. Here's the kicker, even when they ARE colonized,

you will not find an infection control employee that will tell you that

they are no longer communicable. Personally, I would question the

relevancy and usefulness of bringing up their MRSA history any more than

another previous medical condition that is unrelated to what you would

be working on in therapy. Honestly, I treat every patient that I work

with like they have something that I could easily catch. Does that mean

that I wear gloves and gown? No. However, I religiously practice the

same standard precautions that a conscientious therapist would be

practicing anyway. In doing so, you would be minimizing the possibility

of transmission, but not going overboard to the point that the patient

feels stigmatized. I often wonder about the number of patients that I

work with who are probably positive for any number of " bugs " , but have

not yet been diagnosed (if they ever are).

Thanks,

Curtis

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of Trevor Huffman

Sent: Thursday, August 27, 2009 9:50 AM

To: 'PTManager '

Subject: MRSA

Group:

Our hospital outpatient Rehab department is dealing with an issue in

regards to patients that have MRSA in their past history. I would like

to see how other departments handle this.

When our front office registers the patient, our registration system

pops up a notice of positive for MRSA. This only happens if the patient

is already listed in the registration system. We call the patient to

inform them of this. The majority of these patients are unaware of this

or thought the doctor had taken care of it. They become unhappy with us

that we are informing them of this plus unhappy with the MD that they

did not inform the patient of this. This results in a patient and

referral source satisfaction issue with us.

We also inform them of what it takes to have this removed from the

system (2 negative tests) and what will be required while in our

department. We ask them to wear a mask while they are in the waiting

room or gym area and wipe off the equipment immediately following use.

If they refuse to wear a mask or will be treated in a booth, we treat

them as contact isolation. The booth is then cleaned prior to use by any

other patient.

Do any other facilities require anything similar to this? If so, how are

you handling these issues? If not, are you concerned you could be

spreading MRSA?

Trevor Huffman P.T., M.S., S.C.S., A.T.,C.

Passavant Area Hospital

ville, IL 62650

trevor.huffman@...

<mailto:trevor.huffman%40passavanthospital.com>

[Guest guest]

Mr. Huffman,

Good posting and interesting inquiry. You bring up a legitimate issue

and very often patients are discharged from the hospital prior to having

the " 2 negative tests " completed. Therefore, you have no assurance that

they are colonized. Here's the kicker, even when they ARE colonized,

you will not find an infection control employee that will tell you that

they are no longer communicable. Personally, I would question the

relevancy and usefulness of bringing up their MRSA history any more than

another previous medical condition that is unrelated to what you would

be working on in therapy. Honestly, I treat every patient that I work

with like they have something that I could easily catch. Does that mean

that I wear gloves and gown? No. However, I religiously practice the

same standard precautions that a conscientious therapist would be

practicing anyway. In doing so, you would be minimizing the possibility

of transmission, but not going overboard to the point that the patient

feels stigmatized. I often wonder about the number of patients that I

work with who are probably positive for any number of " bugs " , but have

not yet been diagnosed (if they ever are).

Thanks,

Curtis

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of Trevor Huffman

Sent: Thursday, August 27, 2009 9:50 AM

To: 'PTManager '

Subject: MRSA

Group:

Our hospital outpatient Rehab department is dealing with an issue in

regards to patients that have MRSA in their past history. I would like

to see how other departments handle this.

When our front office registers the patient, our registration system

pops up a notice of positive for MRSA. This only happens if the patient

is already listed in the registration system. We call the patient to

inform them of this. The majority of these patients are unaware of this

or thought the doctor had taken care of it. They become unhappy with us

that we are informing them of this plus unhappy with the MD that they

did not inform the patient of this. This results in a patient and

referral source satisfaction issue with us.

We also inform them of what it takes to have this removed from the

system (2 negative tests) and what will be required while in our

department. We ask them to wear a mask while they are in the waiting

room or gym area and wipe off the equipment immediately following use.

If they refuse to wear a mask or will be treated in a booth, we treat

them as contact isolation. The booth is then cleaned prior to use by any

other patient.

Do any other facilities require anything similar to this? If so, how are

you handling these issues? If not, are you concerned you could be

spreading MRSA?

Trevor Huffman P.T., M.S., S.C.S., A.T.,C.

Passavant Area Hospital

ville, IL 62650

trevor.huffman@...

<mailto:trevor.huffman%40passavanthospital.com>

[Guest guest]

Mr. Huffman,

Good posting and interesting inquiry. You bring up a legitimate issue

and very often patients are discharged from the hospital prior to having

the " 2 negative tests " completed. Therefore, you have no assurance that

they are colonized. Here's the kicker, even when they ARE colonized,

you will not find an infection control employee that will tell you that

they are no longer communicable. Personally, I would question the

relevancy and usefulness of bringing up their MRSA history any more than

another previous medical condition that is unrelated to what you would

be working on in therapy. Honestly, I treat every patient that I work

with like they have something that I could easily catch. Does that mean

that I wear gloves and gown? No. However, I religiously practice the

same standard precautions that a conscientious therapist would be

practicing anyway. In doing so, you would be minimizing the possibility

of transmission, but not going overboard to the point that the patient

feels stigmatized. I often wonder about the number of patients that I

work with who are probably positive for any number of " bugs " , but have

not yet been diagnosed (if they ever are).

Thanks,

Curtis

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of Trevor Huffman

Sent: Thursday, August 27, 2009 9:50 AM

To: 'PTManager '

Subject: MRSA

Group:

Our hospital outpatient Rehab department is dealing with an issue in

regards to patients that have MRSA in their past history. I would like

to see how other departments handle this.

When our front office registers the patient, our registration system

pops up a notice of positive for MRSA. This only happens if the patient

is already listed in the registration system. We call the patient to

inform them of this. The majority of these patients are unaware of this

or thought the doctor had taken care of it. They become unhappy with us

that we are informing them of this plus unhappy with the MD that they

did not inform the patient of this. This results in a patient and

referral source satisfaction issue with us.

We also inform them of what it takes to have this removed from the

system (2 negative tests) and what will be required while in our

department. We ask them to wear a mask while they are in the waiting

room or gym area and wipe off the equipment immediately following use.

If they refuse to wear a mask or will be treated in a booth, we treat

them as contact isolation. The booth is then cleaned prior to use by any

other patient.

Do any other facilities require anything similar to this? If so, how are

you handling these issues? If not, are you concerned you could be

spreading MRSA?

Trevor Huffman P.T., M.S., S.C.S., A.T.,C.

Passavant Area Hospital

ville, IL 62650

trevor.huffman@...

<mailto:trevor.huffman%40passavanthospital.com>

[Guest guest]

Trevor,

We have a more stringent MRSA policy than is required by the CDC or CMS.

The CDC says contact precautions for wounds, urine, anything except

respiratory MRSA. For respiratory MRSA, the CDC ranges from isolation (but

not negative pressure) to staying 3+ feet from the patient without mask, eye

protection, gown, etc. Respiratory MRSA is considered droplet precautions.

That is a wide range and I saw the sneeze movie in elementary school. We

only cohabitate people infected with respiratory MRSA with other people who

have respiratory MRSA. We cohabitate colonized wound, urine, etc. with

those with like infection similar organism. I haven't looked at it in a few

years, but our infection control nurse says she looked at it last winter and

she didn't see significant changes. We consider all people with a history

of MRSA as colonized vs. active based on absence or presence of symptoms.

Sorry, that is a long way around to outpatient. I wanted to give a little

more background. Basically, unless we are doing wound care, we don't do

anything different in outpatient than normal. Clean the mat; clean the

parallel bars, etc. Wounds that are draining and coming through the

dressing are treated with more caution. Most of the MRSA we have seen is

wound or urine in origin.

Respiratory MRSA, we ask for a culture to be obtained a few days after

stopping the antibiotic treatment (I think 3 or 4 days after). We are

looking to see if the infection is active or colonized. If it is active, it

is droplet precautions. If it is active or the person develops respiratory

symptoms, we then isolate and institute mask and gloves (for staff in the

room or for the patient/resident if they leave the closed room).

We have taken a couple VRE patients too. Obviously we use more stringent

infection control in those cases.

It is harder for me than our DNS to translate the CDC site. But, it is

definitely helpful to therapists. It is just cdc.gov. I used it a few

weeks ago to provide educational materials for our LTC nurses about

shingles. Then, we can look at facts and recommendations direct from the

CDC vs. fear or second hand information.

Take care,

Wade

Wade McDowell, OTR, AIT

Assistant Nursing Home Administrator

Director of Inpatient Rehabilitation

Family Health West

Fruita, CO

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Trevor Huffman

Sent: Thursday, August 27, 2009 8:50 AM

To: 'PTManager '

Subject: MRSA

Group:

Our hospital outpatient Rehab department is dealing with an issue in regards

to patients that have MRSA in their past history. I would like to see how

other departments handle this.

When our front office registers the patient, our registration system pops up

a notice of positive for MRSA. This only happens if the patient is already

listed in the registration system. We call the patient to inform them of

this. The majority of these patients are unaware of this or thought the

doctor had taken care of it. They become unhappy with us that we are

informing them of this plus unhappy with the MD that they did not inform the

patient of this. This results in a patient and referral source satisfaction

issue with us.

We also inform them of what it takes to have this removed from the system (2

negative tests) and what will be required while in our department. We ask

them to wear a mask while they are in the waiting room or gym area and wipe

off the equipment immediately following use. If they refuse to wear a mask

or will be treated in a booth, we treat them as contact isolation. The booth

is then cleaned prior to use by any other patient.

Do any other facilities require anything similar to this? If so, how are you

handling these issues? If not, are you concerned you could be spreading

MRSA?

Trevor Huffman P.T., M.S., S.C.S., A.T.,C.

Passavant Area Hospital

ville, IL 62650

trevor.huffman@ <mailto:trevor.huffman%40passavanthospital.com>

passavanthospital.com