The Question: We know there is community acquired MRSA in our area.  Can we see these patients in our facility?

• This is a challenging question and one which will require your governing body and infection preventionist to perform a risk assessment to determine the risk to the facility.   Will they see patients with a history of MRSA or will it be patients with active MRSA?
  • We know that MRSA is a drug resistant form of Staphylococcus aureus that is transmitted through direct contact.  Improper hand hygiene and ineffectively cleaned surfaces can harbor the MRSA bacteria for extended periods of time.
  • Per the CDC, we know that approximately 33% of the population carries the MRSA condition with knowledge.
  • What does the local, state and national data demonstrate regarding community acquired MRSA?

• If the collaborative team decides to proceed with seeing patients with a history or active MRSA, then very specific infection prevention and control methodologies will need to be put into place.
  • Means to identify the potentially infective patient
  • Means to provide care with standard and contact precautions including hand hygiene, gloves, gowns, masks, goggles, patient placement, patient care equipment
  • Means to ensure PROPER HAND HYGIENE 100% of the time and frequent surveillance and education
  • Means to ensure and evaluate EFFECTIVE ENVIRONMENTAL CLEANING strategies 100% of the time between patients in all areas of the facility and terminal cleaning of all areas of the facility.
  • Means to provide dedicated equipment for those in contact precautions
  • Means to ensure and evaluate EFFECTIVE CLEANING OF PATIENT CARE EQUIPMENT following Manufacturer instructions for use
  • Means to educate staff and practitioners, and communicate expectations and infectivity while remaining HIPAA compliant
  • Surveillance methodologies to assess current MRSA transmission rates versus on-going MRSA transmission rates in not only patients, but staff also.  Staff will be susceptible to acquiring MRSA.
  • Investigation and Control Plan in the event there is a MRSA transmission. 

• Develop a written MRSA policy and procedure outlining expectations and procedures.

• There are several resources to assist in the decision making process: 
  • APIC MRSA implementation guide: https://apic.org/Professional-Practice/Implementation-guides#MRSA 
  • CDC-Guide to infection prevention in outpatient settings:  https://www.cdc.gov/infectioncontrol/pdf/outpatient/guide.pdf, and https://www.cdc.gov/mrsa/ 
  • MRSA toolkit for outpatient settings:  http://www.tpchd.org/health-wellness-1/mrsa-methicillin-resistant-staphylococcus-aureus/mrsa-toolkit-outpatient-clinics-offices/