mdro pct & non clinical final-january
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MDRO (Multiple drug-resistant
organisms)
What You Need to Know
UT Southwestern University Hospitals: Infection Control Department
Multi-drug resistant organisms (MDRO’s) are germs which are not killed by many different antibiotics.
Illness caused by MDROs cannot easily be cured by commonly used medicines.
These germs are easily spread to other people. If a patient becomes sick from a MDRO, they
stay longer in the hospital and are at a higher risk of dying.
What is a Multi-drug Resistant Organism (MDRO)?
MRSA: Methicillin-Resistant Staphylococcus aureus
VRE : Vancomycin-Resistant Enterococcus Multidrug-Resistant (MDR) Acinetobacter Multidrug-Resistant (MDR) Klebsiella Multidrug-Resistant (MDR) Enterobacter Multidrug-Resistant (MDR) Escherichia coli C. Diff: Clostridium difficile
Common MDROs and Their Abbreviations
MDROs are spread from one person to another on the hands.
Hands become soiled when touching the patient to give care or when touching surfaces in the room which the patient or other care givers have touched.
When hands are not washed or gown and gloves are not worn in Contact Isolation rooms, the MDRO is more likely to be passed to another patient.
Hands are the culprits
Panel A: THE MRSA GREW AFTER NO HAND WASHING,
Panel B: AFTER USING ALCOHOL FOAM TO WASH HANDS, NO MRSA GREW
Donskey C and Eckstein B. N Engl J Med 2009;360:e3
WASH YOUR HANDS!
Hand washing is the single most important way to prevent the spread of disease
Use soap and warm water ◦Rub for15 seconds
Alcohol-based products◦Wet hands with foam
and rub in◦99% kill rate◦ It has a persistent
effect, and can continue to kill germs
◦Use 6-8 times before washing with soap & water
WASH YOUR HANDS—IT SAVES LIVES!
Hand HygieneStop the Spread of Germs
Touching the PATIENT isn’t the only way to get germs on your hand!
MDROs live on the surfaces in the room where the patient and other care givers have touched.
Standard Precautions are good hygiene practices which apply to all patients, whether they have a MDRO or not.
Standard Precautions are in effect for all patients, all the time—24 hours/Day, 7 Days/Week.
These include: Washing your hands before and after patient contact If coming in contact with body fluids, as needed,
wear: Gloves Gown Mask Goggles or face shield
How to Protect Your Patients, Yourself, and Your Family:
Standard Precautions
Throw away used sharps promptly.
Any equipment or items in the room which may have been soiled:◦ Clean before using again, or◦ Throw the item away
How to Protect Your Patients, Yourself, and Your Family:
Standard Precautions
How to Know a Patient Has a MDRO
Patients with a known MDRO will be placed in isolation
There are 3 types of isolation:◦ Contact◦ Airborne◦ Droplet
A sign on the door will alert anyone entering the room of the isolation type
Good hand washing is the best way to stop the spread of germs.
Contact Precautions may be added to prevent the bugs from being carried from one room to another on equipment or the hands of care givers.
Contact Precautions
A Green Contact Isolation sign will be on the room door.
Any PERSON entering the room wears gloves and gown, no matter the reason for entering the room or for how long. This includes all staff and visitors.
Contact Isolation Precautions
Contact Isolation Precautions
Remove the gloves and gown and wash hands BEFORE leaving the room.
Equipment from a Contact Isolation room should be cleaned before being used in the care of another patient.
Contact Isolation Precautions Sign
Contact
Sign Color Fluorescent Green
Type of Bug Isolated
MRSA
VRE
Clostridium difficile
Lice
Scabies
Procedure for Isolation
Wash Hands
Don Gown & Gloves BEFORE entering room
REMOVE Gown & Gloves BEFORE leaving room
Wash hands-- Soap & water only if C. diff, otherwise use alcohol foam when leaving room
C. difficile
Sign Color Red Stop Sign
Type of Bug Isolated
Clostridium difficile
Procedure for Isolation
Wash Hands
Don Gown & Gloves BEFORE entering room
REMOVE Gown & Gloves BEFORE leaving room
Wash hands--SOAP & WATER ONLY when leaving roomStop Sign for Clostridium difficile
Contact Precautions+
Use ONLY soap & water to wash hands
Droplet Precautions
A Yellow/Orange Droplet Isolation sign will be on the room door.
Surgical mask required for staff and visitors
Surgical mask for patient if transport out of room required
Droplet
Sign Color Fluorescent Yellow/ Orange
Type of Bug Isolated
RSV
Influenza
Meningitis
Procedure for Isolation
Wash hands
Don Surgical Mask
REMOVE Mask when leaving room
Wash Hands after leaving room with soap & water or alcohol foam
Droplet Isolation Precautions Sign
Airborne A Hot Pink Airborne
Isolation sign will be on the room door.
Negative Pressure Room (318, 319, 426, 566, 567, 718, 719, MSICU - 4 rms)
N95 Mask for staff
Surgical mask for patient if transport out of room required
Duckbill masks for visitors
Airborne
Sign Color Hot Pink
Type of bug Isolated
AFB (Tuberculosis)
Measles
Chicken Pox
(Any staff who have NOT had measles or chicken pox or been vaccinated MAY NOT ENTER patient room.)
Procedure for Isolation
Don N95 mask BEFORE entering room
(Staff must have been fit tested by Occupational Health for appropriate size upon hire.)
Wash Hands
REMOVE Mask when leaving room
Wash Hands after leaving room with soap & water or alcohol foam
Airborne Isolation Precautions Sign
Fact:Patient-to-patient spread of germs can be prevented.
Actions:Use standard precautions Minimize contact with infection-causing body
fluids Use approved airborne/droplet/contact isolation
precautionsWhen in doubt, call infection control
Prevent Spread—What You Can Do
Infection Control has found that patients from Long Term Acute Care (LTAC) facilities usually have a MDRO, either now or in the past
Nursing staff will place them in Contact Isolation immediately upon arrival, no questions asked!
Call Infection Control if you have any questions
Prevent Spread—What You Can Do
Fact: People spread germs from patient to patient.
Actions:Stay home when you are sick Cover your cough or sneeze with a tissueKeep your hands cleanSet an example!
Prevent Spread—What You Can Do
The Infection Control Team
Doramarie Arocha
Gwen Way
David Townson