Nursing Quality Assurance
Reducing the Risk of Transmission of Methicillin-Resistant Staphylococcus Aureus (MRSA) in Healthcare Facilities Infection control is one of the things we as nurses and nursing students have a commitment to take every possible step to ensure. Infection control includes all things that are avoidable and by practicing by the ANA Code of Ethics and QSEN Competencies we can ensure that patients get best possible care they deserve. It is important that all people involved in the care of patients in a health-care facility take all the necessary steps and precautions to avoid spreading germs that can cause infections.
It is essential that the policies put in place to control these problems are followed by every member of the collaborative team. According to the QSEN Competencies every person involved in the care of a patient should “Function competently within own scope of practice as a member of the health care team”. (QSEN, 2010) This includes nurses, doctors, social workers, janitorial services and dietary aids, to name a few. Each person working in a health-care facility plays an important particular role in the care of the patients.
It is necessary to explore this issue because patient safety is a priority. It is important that everyone abide by the facility policies to decrease risk of transmission of infectious organism to patients, increase awareness to risk of transmission of MRSA and keep the patients and healthcare workers safe. One thing that has been difficult to control in hospitals is the spread of MRSA. MRSA (Methicillin-Resistant Staphylococcus Aureus) is a bacterial infection which is easily spread that can be highly resistant to antibiotics. There are two ways that one could acquire a MRSA infection.
Community-associated MRSA infections can occur in healthy people living in the community who have not recently been in the hospital. MRSA is spread through direct contact with the infected person or items used by that person. People in close proximity or who share personal items or athletic equipment are at an increased risk of acquiring a MRSA infection. Another way that MRSA can be spread which is much more prevalent is through a hospital. Healthcare-associated MRSA infections occur in people who have recently been admitted to the hospital or other health-care facility.
People who have been hospitalized or had surgery at an increased risk of contracting a MRSA infection. According to Fairclough (2006), “MRSA accounts for one-fifth of hospital acquired infections”(p. 73 ). The incidence of contracting a MRSA infection can be fairly minor to very serious. The prognosis of a patient who acquires a MRSA infection depends solely on the severity of the infection and the person’s overall health. Reducing risk of MRSA transmission can be extremely effective if all members of the collaborative team follow all necessary measures to eradicate MRSA. Attempts to control the spread of MRSA rely on several factors: detecting and isolating infected or colonized patients, rational antibiotic prescribing, hand hygiene and cleanliness. ” (Fairclough, 2006) “Infection control is at the heart of quality clinical care. Clinical governance provides the framework to demonstrate the value of infection control to all healthcare workers. ” (Bissett, 2005, p. 386) Of the many steps necessary to reduce the risk of spreading MRSA infections the first step is screening of all patients to be admitted to the facility.
This has become controversial as it is costly to test all patients for possible MRSA infections but it is necessary if the goal is to eliminate transmission of MRSA from patient to patient. “Nosacomial transmission of MRSA is so widespread that screening programmes have been implemented to control the spread of MRSA in the hospital environment. ” (Banning, 2005, p. 548) If healthcare facilities are able to properly identify the patients whom are infected with MRSA then they will be able to successfully carry out policies to protect others, especially those who are at high risk for infection.
Once the patients with MRSA have been identified then the precautions protocols can be determined. According to Bissett (2005) the most effective type of precaution for MRSA patients is isolation of the source. (p. 389) Patients should be placed in single rooms and have certain medical equipment dedicated to them. Healthcare workers should use contact precautions and person protective equipment. All persons entering the room of a patient with MRSA should be wearing gloves and a gown. It is important that are healthcare workers understand and are in compliance with infection control measures. Bissett (2005) stated the following:
Although MRSA can be transferred by patient to patient contact and air-borne transmission, it usually occurs via the hands of healthcare workers. It should not be forgotten that the need for environmental cleanliness. compliance with standard infection control precautions, including risk assessment of tasks to ensure the appropriate use of gloves and efficient hand hygiene, are of equal importance as isolation and cohort nursing. It is, therefore, important that all staff are updated annually on standard infection control precautions and that hand hygiene is kept high on the agenda of all staff members. p. 389) This is a clear explanation of the QSEN Competency “Value the need for continuous improvement in clinical practice based on new knowledge”. (QSEN, 2010) All healthcare professionals should be updated on current infection protocols and should use evidence-based practices to develop their scope of practice. “Healthcare providers and patients need to be educated about MRSA skin infections and preventative measures. Standard precautions should always be utilized: hand washing, using gloves, and decontaminating linens and surfaces. ” (Romero, Treston, O’Sullivan, 2006, p. 22. The final and arguably most important step healthcare professionals need to take to reduce the risk of MRSA transmission is proper hand hygiene. Hand washing should be done before and after coming in contact with all patients. An antimicrobial hand wash should be used when coming in contact with a patient with MRSA. Proper hand hygiene is the most effective way to reduce the risk of transmission of any type of infection to patients or the healthcare workers themselves. Although the main goal is to keep patients safe and free of hospital acquired infections, the hospital can also be held accountable for improper infection control.
Reimbursement for treating nonsurgical hospital-acquired infections is being eliminated because it is believed that the use of evidence-based practice can reduce these infections. Hospitals are also required to report any incidences of hospital-acquired infections. “At present if a patient contracts MRSA, the hospital has a mandatory requirement to notify the HPA (by recording it on a website) and the incident will be recorded on the statistics. The idea, of course, is for the statistics to reflect any increase or decrease in the incidence of these superbugs.
The HPA figures have been referred to extensively in the press, sometimes with rejoicing in the decrease in MRSA. ” (Rawson, 2008, p. 72)If the infection control protocols at the facility are followed properly, the risk of transmitting MRSA from patient to patient can be drastically reduced. “The decrease in MRSA does, however, suggest that obliging hospitals to report cases of MRSA to the HPA plays a role in reducing the incidence. ” (Rawson, 2008, p. 73) As for continued research on MRSA prevention, it is important to focus on effectiveness of interventions already in place and readjustment as necessary.
Using gowns and gloves for all MRSA contact precaution rooms may be the protocol, but protocols are not always followed. More research needs to be conducted on the compliance of these standard precautions. Decreasing the risk of infection transmission is only effective if all members of the healthcare system collaborate and follow the protocol together. Infection control and patient safety are primary goals for each patient in a healthcare facility. It should be acknowledged that acquiring a healthcare-associated infection such as MRSA can be regarded as an indicator of the quality of care at that facility.
That is a chance any patient should not have to take. Research Log Duncan, C. P. , Dealey, C. , (2007) Hand hygiene. Patient’s feelings about hand washing, MRSA status and patient information. British Journal of Nursing, 16(1), 34-38 I did not use this article, although it was very interesting, it wasn’t as closely related to my topic as the others. Leifer, D. , (2005) MRSA hotspots. Nursing Standard. 19(52) 7-13. This was an interesting article on regions which have a higher prevalence of MRSA. It was shocking, but I decided not to use the article because the statistics on areas with high MRSA incidence were Europe based.
Thomas, R. P. , Raymond, M. K. , (2009) Dishing the dirt on MRSA. RN 72(6) 16-23 This was a good article but seemed to focus more on patient education, information and signs and symptoms rather than a focus on the healthcare system. References Banning, M. , (2005) Infection control nursing. Transmission and epidemiology of MRSA: current perspectives. British Journal of Nursing, 14(10), 548-551. Bissett, L. , (2005) Infection control. Controlling the risk of MRSA infection: screening and isolating patients.
British Journal of Nursing, 14(7), 386-390. Fairclough, S. J. , (2006) Infection control. Why tackling MRSA needs a comprehensive approach. British Journal of Nursing, 15(2), 72-75. Rawson, E. , (2008) The tip of the superbug iceberg. Clinical Risk. 14(2), 72-76. Romero, D. V. , Treston, J. , O’Sullivan, A. L. , (2006) Hand to hand combat: Preventing MRSA…methicillin-resistant staphylococcus aureus. Nurse Practitioner. 31(3) 16-18, 21-25. QSEN. Quality and Safety Education for Nurses. (2010) Retrieved from: http://www. qsen. org/competencies. php