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When Kathleen Byrne, BSN, RN, ICP, takes her clipboard in one hand and pen in the other and goes on one of her hand hygiene audits, she doesn't always like what she discovers.
As infection control specialist at Triumph Healthcare's acute care center in Houston, Byrne takes a first-person approach to preventing the spread of methicillin-resistant Staphylococcus aureus (MRSA) on the floors of three healthcare facilities. These periodic audits allow her to observe hand hygiene among clinicians and determine if they are being diligent about washing before and after each patient visit.
"Hand washing is the best preventive measure we have against MRSA," said Byrne.
She also takes note of the application of gel and foam solutions and if clinicians are washing hands correctly and long enough to kill bacteria. One of her recent audits of 71 observations produced a compliance rate of 61.9 percent: "not good," she said, yet that figure is still drastically better than a previous rate of 13 percent.
But her efforts don't end there. She also carries over prevention lessons to patients and families when it's time for discharge.
"People at home think everything is fine, so they don't think of these things," said Byrne. "It's important to provide education about the basics of MRSA and how to take precautions to prevent its spread."
Resistant Bacteria
Since MRSA is a bacteria that's resistant to certain antibiotics, such as methicillin, penicillin and amoxicillin, staph infections, including MRSA, can occur among people with weakened immune systems in hospitals and nursing homes, according to the CDC.
MRSA infections that occur in people who are relatively healthy, who haven't been hospitalized or had a recent medical procedure, are known as community-associated MRSA infections. These problems are often skin infections, such as boils, abscesses and pus-filled lesions.
MRSA has been an issue in healthcare facilities for years, but media attention in the last several years has intensified its prominence in the public lexicon, said Brenda Helms, MBA/HCM, BSN, RN, infection prevention specialist and employee health coordinator at The Heart Hospital of Baylor Plano in Plano, TX.
"Originally MRSA was found only in healthcare institutions and now it is just as common, if not more common, in the community," she said. "It is found in schools, gyms, public bathrooms and many other public areas." People may even mistake an MRSA skin infection for a spider bite, she added.
When it comes to MRSA, "you can't just say it's a bacteria," said Byrne. And each person's resistance is different. "Some people are colonized with it and have had it so many times they've become immune to it and it doesn't bother them," said Byrne, "and with another person it becomes a raging infection."
Many hospitals now screen for MRSA during admission in order to identify people who are colonized with it, said Helms. This allows healthcare facilities to isolate MRSA carriers to prevent the spread of the bacteria.
Aside from good hand hygiene controlling infections in a draining wound is also important in halting the spread of MRSA. Helms emphasized any drainage should be contained within a bandage and that proper dressing change techniques are used in the hospital and home.
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