This is a potential problem on the unit. We currently screen all admissions. If a patient is identified as MRSA positive, there are risks to the patient and to other patients. In the ICU situation we cannot expect to eradicate MRSA from a patient, due to all the invasive lines, tubes etc. So once a patient has MRSA he/she should be considered MRSA positive for the rest of their ICU stay (there is no point doing multiple screens for MRSA in these patients). We can, however, attempt to reduce the bacterial load and thereby reduce the risk of cross infection. We audit the cross-infection rate on the ICU and in consultation with the microbiologists have agreed the following policy.
All patients with MRSA must have
- Red Aprons at the bedside to alert staff to the risks.
- Daily Aquasept (2% w/v Triclosan) bed baths -this must be prescribed.
- If the MRSA is Bactroban (mupiricin) sensitive this should be applied topically to the nasopharynx - again this requires a prescription.
- All appropriate wounds should have Inodine (slow release iodine) dressings (e.g. central lines).
- Gloves should be worn by all staff when handling the patient, patient related material or bedding.