Daily_Care_of_Client_with_Mrsa

Care Skills: D20163 Daily Care of a Client with MRSA MRSA stands for Methicillin-resistant Staphylococcus aureus. Staphylococcus aureus is usually a non pathogenic bacterium that resides on the skin, in the nose or throat of about one third of the population. http://www.oxfordradcliffe.nhs.uk/forpatients/infection_control/mrsa.aspxIt only becomes pathogenic when it gains access to deep tissues, usually via broken skin, the blood steam, the lungs or the urinary tract. Most people carry the bacterium harmlessly, this is called colonisation. MRSA is transmitted through skin-to-skin contact or through contact with items contaminated by infected sites. There are many factors to take into consideration when caring for a client who has MRSA ,such as risk of exposure to you, other patients, and trying to minimise the spread of infection, as outline in the HSG65 model. Under common law it is important for emplorers to provide • A safe place of work • Safe plant and epuipment • A safe system of work • Safe and competent employees Good infection control practises must be used for all clients, not just those known to have MRSA. One of the most important things in infection control is proper hand hygiene. Hands should be washed in accordance to the guidelines set out by SARI. Using proper hand wash\anti bacterial gel, and following the 5 steps for a minimum of 30 seconds. Indications to wash hands are as follows: • When hands are visibly contaminated with dirt, soil or organic material. • Before and after each client contact. • After moving from a contaminated to a clean area. • Before putting on and after removing gloves. • After personal bodily functions, such as blowing nose or using the toilet. • After handling soiled equipment, materials or environment. • Before preparing or handling food. The first thing you should do before coming into contact or entering a room of a client who has MRSA is put on a plastic apron and to remember to double glove. This prevents the transmission of MRSA on the health care workers clothing to other areas of the nursing home. Gloves are essential when in contact with blood, body substances or mucous membranes, as it will provide a barrier to the transmission of MRSA to other patients and to you. Once you have finished with the client, you must dispose of the gloves and apron in a tied plastic bag, preferably in a non permeable bin, (refenced to risk assessment handout from HSE). Gloves and aprons should only be used once. Cuts or breaks in the skin of the care giver should be covered with an impermeable dressing. The bed linen of the client should be changed and washed when needed and on a routine basis. The linen and clothes of a patient who has MRSA should be put into alginate bags in accordance with legislation, and washed with a disinfectant at a high temperature. Surfaces in the client’s room should be cleaned on a daily basis, with disposable cloths or disinfectant wipes. Any cleaning product should be left on surfaces for a minimum of 20 seconds, and once wiped off should be cleaned again. It is important that clients don’t share personal items such as towels, washcloths, razors, clothing, etc. The resident with MRSA should be encouraged to practise good personal hygiene and be assisted with this if their physical or mental condition makes it difficult for them to do themselves. This is necessary in removing MRSA from the skin of colonised clients. If a patient with MRSA is being transferred back to a nursing\care home, the staff and GP should informed before hand. Although there is little risk of infection to healthy people, clients colonised or infected with MRSA should not be placed in rooms with debilitated patients as it poses a higher risk of infection. Clients, where possible should be placed in single rooms, or co habit with others who also have MRSA. Clients should not be isolated, as this may adversely affect their mental and physical well-being. The psychological impact of these precautions on patients should try to be minimised. Encourage visitors by not overstating the risks to them. Although contact precautions are to be used, it is important to ensure that quality interaction with the patient occurs. Those who are infected may join other residents in communal areas such as the sitting room and dining rooms providing their sores or wounds are covered properly with an appropriate dressing. Care givers must also keep into consideration the privacy of the client. Although it is important to make sure risk of infection to others is minimised, they are not entitled to know the condition of the other patients as they under law are still entitled to confidentiality and privacy. While it is important to insure correct protocol is followed, it is also equally important not to forget about the client as a person. It is important to make sure throughout all off this that they retain their sense of dignity. Making sure to treat them as an individual instead of just treating the condition is vital in them retaining a positive self image. MRSA causes serious illness and results in significant additional healthcare costs. It is an important patient safety issue that needs addressing. Surveillance of MRSA should be undertaken in a systematic way and should be fed back routinely to healthcare staff. Routine swabbing should be implemented in care homes and settings as to become aware of who is infected or colonised. This will make treatment and prevention easier with a better understanding of the different strains of the super bug. This is a quick and painless procedure involving rubbing a cotton bud in the nose and on any area of broken skin. http://www.oxfordradcliffe.nhs.uk/forpatients/infection_control/mrsa.aspx The inappropriate or unnecessary use of antibiotics should be avoided, and this will also reduce the likelihood of the emergence and spread of strains of infection. The general and specific measures implemented to control MRSA will help contain the emergence and spread of other antibiotic-resistance bacteria, minimise adverse patient events in terms of hospital or institution-acquired infections, contribute to the containment of healthcare costs and finally, enhance the overall quality of patient care. Even though I have never worked with a client who has MRSA I feel I would know the correct means of care and procedures to follow to insure the best level of care is given to the client, but while also minimising the risk to myself or other patients.