MRSA - Preventing Methicillin-Resistant Staph Infections in Healthcare and the Community
Published: 18 February 2018
Published: 18 February 2018
Though commonly associated with healthcare acquired infections (HAIs), MRSA is not only confined to hospital and healthcare settings, but can also exist in ‘community-acquired’ forms (CaMRSA).
CaMRSA can lead to:
The NSW Government (2012) highlight that anyone may acquire, in particular, skin infections, from CaMRSA, but the main people at risk are those with health conditions such as diabetes, low immunity or broken skin.
There is a need to promote hygiene to prevent the spread of CaMRSA, as common modes of transmission (NSW Government, 2012) can involve:
Department of Health (n. d.) highlights that intravenous (IV) catheters can also be a portal of entry for bacteria to get into the bloodstream. Nurses and healthcare staff need to pay attention to signs such as:
Lopez-Alcalde et al (2015) completed a study into MRSA in the hospital setting and similarly found that there was not enough evidence surrounding MRSA transmission in the hospital setting in relation to glove, gown and mask use.
The study did, however, highlight from its background/summary that in hospitals, MRSA is namely spread by health workers (Lopez-Alcalde et al, 2015).
This can occur due to the worker (e.g. their hands, clothing, equipment etc) becoming contaminated by the infected person being cared for, and then the worker coming into contact with other clients and their environments (Lopez-Alcalde et al, 2015).
In the prevention of MRSA, nurses and healthcare professionals have a responsibility to:
(Department of Health n. d.)
Nurses and other healthcare workers may be able to contribute to the prevention of CaMRSA via the implementation of health education for at-risk clients in particular, but also general community members.
Education could involve prevention strategies such as:
(NSW Government, 2012)
Hughes, Tunney and Bradley (2013) highlighted that hospital practices such as isolation can be difficult at times, for example within aged care residential facilities.
Hughes et al. concluded in their systematic review that nursing homes could consider screening clients at risk of MRSA. This could involve swabbing clients that have been transferred from a hospital setting.
The review also raised a practical point that key educators within facilities should be properly trained and educated regarding control and prevention of infections, as well as hand hygiene and thorough cleaning/decontamination processes. It was concluded by Hughes et al (2013) that increased research into MRSA practices in nursing home settings is necessary.
Gurusamy et a.l state in their 2013 study that it is ‘not clear whether antibiotics should be used in MRSA colonised non-surgical wounds’.
Their study aimed to investigate this question, but there were no trials comparing antibiotic use to no antibiotic use for participants with ‘MRSA-colonised non-surgical wounds’ (Gurusamy et al, 2013). This study highlighted another needed area for MRSA research; this being the identification of best practice for non-surgical wounds that have MRSA (Gurusamy et al, 2013).
For any healthcare professionals interested in conducting further research into MRSA prevention, Hughes et al. (2013) convey that ‘future studies could also be designed which examine a specific component of infection prevention and control in the nursing home setting, e.g. hand hygiene or isolation procedures versus usual care or a comprehensive infection prevention and control strategy.’
Their study further recommended that any researcher interested in this field look into the original study as well as other high-quality systematic reviews to note exact research needs on MRSA and CaMRSA.
Madeline Gilkes, CNS, RN, is a <a href="https://www.lifestylemedicine.org.au/fellows" target="_blank">Fellow of the Australasian Society of Lifestyle Medicine</a>. She focussed her master of healthcare leadership research project on health coaching for long-term weight loss in obese adults. In recent years, Madeline has found a passion for preventative nursing, transitioning from leadership roles (CNS Gerontology & Education, Clinical Facilitator) in hospital settings to primary healthcare nursing. Madeline’s vision is to implement lifestyle medicine to prevent and treat chronic conditions. She is planning to complete a PhD in health education, and currently works mostly in the role of Head of Nursing. Madeline’s philosophy focuses on using humanistic management, adult learning theories/evidence and self-efficacy theories and interventions to promote positive learning environments. In addition to her master of healthcare leadership, Madeline has a graduate certificate in adult and vocational education, graduate certificate of aged care nursing, and a bachelor of nursing. Madeline is currently nearing completion of a graduate certificate of diabetes education and management. See Educator Profile