It is very important that caregivers follow contact and barrier precautions with a patient that has MRSA.
- Environmental cleaning is important and any bandages that are changed should be done with gloves on and the bandages be put immediately in a plastic bag that is tied shut and disposed of promptly.
- Follow the hospitals discharge sheet (one should be provided) for MRSA and look for any signs of change of condition of the patient such as: temperature increase, change in wound or skin infection (increase in redness, pus, swelling or warm to the touch). If a change occurs, immediately call the patients doctor and describe the changes in condition.
- Continue to clean surfaces in the home with a disinfectant and also wash clothing, towels, bedding, etc. frequently in hot water with bleach. No members of the household should share any personal items such as: towels, clothing, razors, etc.
- MRSA infections can be very persistent and colonization (carrier) between household members is common. It is highly recommended that all members of the household be tested (MRSA screening) if recurring infections continue to happen. The MRSA test is a simple nasal swab and results are back in 2-3 days. DNA rapid testing may also be available and results can be back in one day.
- Decolonization – those who test positive for MRSA (carrier) can be decolonized by a doctor prescribing a five-day antibiotic ointment to be put in the nares (nostrils) and usually prescribed for five days. Chlorhexidine bleach baths should be done several times and can be purchased in any drug store. Diluted household bleach in the bath can be also used, but not used on the face or infected area.
- Emotional issues – many MRSA patients will have a change in their mood or personality due to medication and results from prolonged illness and recurring infections. Anger, depression, anxiety and (PTSD) post traumatic stress disorder are all common. If these symptoms continue, a healthcare professional should be sought who has experience treating the above mentioned conditions. These conditions are currently not being addressed by the most in the healthcare field and MRSA patients can have a sense of isolation and withdraw from everyday life. To completely heal, the emotional side of this disease needs to be addressed.
In The Healthcare Facility
Being a Patient Advocate
All patients entering a healthcare facility for any reason needs a family member or friend to be their Patient Advocate. This means that it is a person who will interact with the healthcare staff, ask questions, write down instructions and help a patient navigate through a medical ordeal while in the healthcare facility and also while at home recovering. This is extremely important for MRSA patients as it is still common for healthcare facilities not to give complete information to patients who have contracted MRSA in a healthcare facility. An example of this is that a patient might be told that they have a staph infection, but not be told that it is MRSA. Patient Advocates need to do the following:
- Look at the patients chart and learn to read the nurses notes, doctor’s orders, lab results, etc. and ask questions of the RN or charge nurse on duty. Carry a small notebook with you at all times to write notes and questions.
- Find out when the attending physician and (ID) infectious disease consult make their daily rounds, be present and have a list of questions prepared.
- Ask what type of strain of MRSA (it should be sub-typed) and what is the course of action. Course of action is; what is the antibiotic therapy, is surgery going to be involved
and estimate of duration of stay or recovery, prognosis, etc.
- Preparations and services might be needed for assistance when the patient returns home or temporary placement in a nursing home or rehab hospital.
- When the patient is discharged, a discharge sheet with instructions should be given to the Patient Advocate. The Patient Advocate should write in their small notebook any questions and more detailed instructions. Instructions can include; what medications the patient is taking and when, physical therapy orders from the physician, lab tests that need to be done and any other follow-up doctor visits or appointments.
- Interact with the patients’ health insurance carrier or whichever provider they are using for healthcare. Also each hospital has a social worker who can be consulted for any information about social services that might be available for the patient in receiving assistance.
A Patient Advocate is the lifeline for the patient and one that is very actively involved can help to reduce medical errors and inadvertent harm that can happen. Many MRSA patients are very ill and will leave a healthcare facility with a chronic disease and not have the ability or knowledge to navigate the healthcare system alone. Patient Advocates save lives – become one to a family member or friend because at some time in a persons’ life, they will have a healthcare crisis and visit and will need the same assistance.