Brandi's Policy Paper

Policy Paper

BACKGROUND
MRSA, or methicillin- resistant staphylococcus aureus, or multiple- resistant staphylococcus aureus is a certain strain of bacteria that is resistant to the antibiotics used to treat staph infections (1). Staphylococcus aureus or S. aureus is the actual bacteria strain that becomes resistant to the antibiotics which were used to treat it. S. aureus is a very dangerous infection that needs to be watched under a very critical eye. The short and common name used by society for S. aureus is “staph” (3). MRSA is a new and emerging infection that was brought to the communities’ attention recently (5). Since MRSA has been brought to the attention of the population there have been two separate types of MRSA: hospital acquired methicillin- resistant S. aureus (HA-MRSA)and community- acquired methicillin- resistant S. aureus (CA-MRSA) (5). The names are the detail to where each type was acquired.
S. aureus’ habitat is the moist anterior nostrils of the nose on around 20% of the population (2). While 60% of the population is intermittent carriers and the last 20% of the population will never come in contact with the bacteria S. aureus (2). There is little to no evidence known about how the bacterial factors affect the colonization of S. aureus in the anterior nares of the nose (2). Previous to the 1940’s a staph infection was considered to be fatal until the production of penicillin (4). “Penicillinase-producing strains soon emerged; methicillin and other penicillinase-stable beta-lactam agents filled the breach (4).” This means that penicillin and penicillin based antibiotics were the choice of many physicians as the treatment for S. Aureus. The methicillin- resistant strains of S. aureus then showed up. These MRSA strains are resistant to all beta-lactam agents (4). MRSA affects acute and chronic wounds which makes it a leading cause of colonization and infection (5). MRSA transmission includes the 20% of the population hat are carriers, they do not show any signs or symptoms of having MRSA but they are the number one way of transmission from person to person (1). MRSA affects patients who are in hospitals, nursing homes, dialysis centers with a weak immune systems, surgical wound infections, urinary tract infections, catheters, bloodstream infections, and pneumonia. MRSA needs to be stopped before it progresses in the body. Healthcare workers need to follow standard precautions to prevent MRSA from infecting patients or people in the community. If patients do acquire MRSA health workers need to pay more attention to their health.

POLICY

A. Contact isolation precautions should be used at all times when in a room with a patient who has MRSA infection. Contact isolation is wearing gloves and gowns while in the room of the infected patient.
B. To prevent MRSA surgical wounds and catheters need to be checked every hour for infectious symptoms. Dressing will also need to be changed during that time. Changing of the dressing should clean with sterile technique using sterilized equipment to change and apply new gauze. With the catheters, the insertion site needs to be checked every hour.
C. For a patient with MRSA personal items should be shared. Personal items that come in contact with skin to skin are the most dangerous items.

CONCLUSION
One counter argument for my policy would be the price rise from having to change the wound dressings every hour. But even though that will end up costing the hospital then following the patient price of the hospital stay that will be preventing the occurrence of MRSA in hospitals. Preventing the MRSA infection from even beginning in the body that will reduce the time and cost of the hospital stay. What little money is spent on checking the wounds every hour will actually be preventing the longer stays due to MRSA. Another counter argument for the policy is that checking the wounds every hour will be too time consuming for the nurses in the health care facilities. For that to be correct nurses will not be doing their job. Nurses have to be constantly checking their patients and making sure everything is following as designated on the patients care plans. MRSA is a very dangerous infection that needs to be prevented before it spreads. With the policy proposed prevention of MRSA will be increased with hopefully a decrease in the number of cases of MRSA.

References
1. CDC (Emerging Infectious Diseases), “MRSA: Methicillin- resistant Staphylococcus aureus in Healthcare Setting”. October 17, 2007. Date obtained September 24, 2008. http://www.cdc.gov/features/Mrsa/
2. Foster, Timothy. “The Staphylococcus aureus “superbug.” The American Society for Clinical Investigation. (2004) Volume 114, Issue 12. http://www.jci.org/articles/view/23825
3. CDC. “NIOSH Safety and Health Topic: MRSA and the Workplace”. November 13, 2007. Date obtained September 24, 2008. http://www.cdc.gov/niosh/topics/mrsa/
4. Google Scholar. Henry F. Chambers, M.D. “Community-Associated MRSA — Resistance and Virulence Converge” The New England Journal of Medicine. April 7, 2005
5. Pub Med. Robert H. Demling, MD and Barbara Waterhouse, PhD. “The Increasing Problem of Wound Bacterial Burden and Infection in Acute and Chronic Soft-Tissue Wounds Caused by Methicillin-Resistant Staphylococcus aureus”. Journal of Burns and Wounds. November 16, 2008. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2104747

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