HOSPITAL-ACQUIRED INFECTION/MRSA EYERUSALEM KIFLE AND GIFT IMUETINYAN OMOBOGBE PNURSS15
INTRODUCTION DEFINITIONS SIGNS AND SYMPTOMS RISK FACTORS DIAGNOSIS COMPLICATIONS PREVENTIONS TREATMENT PATIENT EDUCATION REFERENCES TABLE OF CONTENT
INTRODUCTION HOSPITAL-ACQUIRED INFECTION Hospital-acquired infection(hai) is a nosocomial infection acquired in hospitals by patients who are admitted for a reason other than that infection. HAI may occur 48-72 hours of admittance to the hospital or within 10 days from discharge. PREVALENCE The centers of Disease Control and Prevention (CDC) estimate that 1 in 20 hospitalized patients will contract an HAI. The World Health Organization estimates, on average, 8.7% of hospitalized patients worldwide have HAIs at any one time, with the highest frequencies being reported in the Eastern Mediterranean and Southeast Asia regions (11.8% and 10.0% respectively).
DEFINITIONS METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS(MRSA) -Methicillin resistant staphylococcus aureus(mrsa) is a strain of staphylococcus aureus isolates that is betalactamase resistant staphylococcus antibiotics. -MRSA is a bacteria resistant to methicillin antibiotics and other antibiotics. -MRSA can be transmitted to patients via human hands, mainly those of health care personnel, invasive medical devices that have been in contact with MRSA, either through direct contact with an infected or colonized person or from contact with a contaminated surface or person who has not appropriately sanitized their hands can transmit MRSA. MRSA skin infection can be transmitted from person to person if there is skin-to-skin contact where there is an opening in the skin tissue such as abrasions, cuts, lesions, or boils. MRSA can also contaminate surfaces outside the body when touched by an infected person.
SIGNS AND SYMPTOMS The infected area might be RED SWOLLEN PUS-FILLED WARM TO TOUCH EXTREMELY PAINFUL Other possible signs and symptoms include: CHILLS HEADACHE JOINT PAIN LOW BLOOD PRESSURE RASH THAT COVERS MOST OF THE BODY FEVER
Risk factors of MRSA include: 1. Previous hospitalization 2. Recent antimicrobial therapy 3. Indwelling vascular devices RISK FACTORS 4. Prior invasive or surgical procedures 5. Hospital-level incidence and size 6. Age for instance the elderly 7. Residence in long-term care facility 8. Immunocompromised state
DIAGNOSIS To accurately diagnose MRSA, clinical symptoms, laboratory test such as blood culture test and molecular test are considerable method but the most accurate and fastest is the Real-Time PCR(polymerase chain reaction).
COMPLICATIONS MRSA can lead to life-threatening illness such as septicemia and pneumonia. It is the most common cause of hospital acquired surgical sit infection, bone infections, skin and soft tissue infection, Necrotizing Fasciitis(NF),abscesses and central catheter associated bloodstream infection(clabsis).
PREVENTION Maintaining a good hand hygiene and universally accepted wound care procedure are major factors to prevent MRSA. standard precautions include the importance of hand washing in reducing infections, barrier protections (gloves, gowns, etc.), the safe disposal of sharps and the proper handling of potentially infectious waste materials. When a patient is diagnosed with MRSA, it is best to assign a single room with a bathroom, in some cases two MRSA infected patients may share the same hospital room. To reduce the spread to other patients.
TREATMENT The first procedure is to transfer MRSA- diagnosed patient to MRSA (infectious disease control) unit.. Secondly, the decolonization process which consists of a five-day series of daily whole body washing with cyldimonium chloride, mupirocin (nasal ointment) 2 times per day, and Corsodyl mouth rinse (chlorhexidine gluconate 0.2 %, undiluted) 10 ml per day will be started. All the swab tests results should show negative results to finish the treatment. Follow up after discharge is necessary.
PATIENT EDUCATION Preventive patient education must entail proper hand hygiene washing hands with soap and water, antibacterial/alcoholbased hand sanitizers are preferable. skin hygiene when cut and lesions occur in the skin (it is a good practice to wash with water and cover wounds or non-intact skin using bandages and wound dressing to prevent exposure of the skin to bacteria). pain management. health maintenance which includes proper nutrition, exercise, smoking cessation and maintaining effective immune system through stress avoidance and relaxation. Effective patient and family education should involve verbal explanation of important information about MRSA in such as a way as to increase their awareness about the infection,
REFERENCES Jacobs A. Hospital-acquired methicillin-resistant staphylococcus aureus: Status and trends. Radiol Technol. 2014;85(6):623-652. http://search.ebscohost.com/login.aspx?direct=true&db=ccm&an=103968200&site=ehost-live. General information about MRSA in healthcare settings. Centers for Disease Control and Prevention Web site. https://www.cdc.gov/mrsa/. Published May 22, 2017. Updated 2015. Accessed 2.2., 2018. Nazarko L. Methicillin-resistant staphylococcus aureus (MRSA): A guide to prevention and treatment. BR J HEALTHC ASSIST. 2014;8(8):377-383. http://search.ebscohost.com/login.aspx?direct=true&db=ccm&an=103984568&site=ehost-live. Noble DB. Patient education on MRSA prevention and management: The nurse's vital role. Medsurg Nurs. 2009;18(6):375-378. http://search.ebscohost.com/login.aspx?direct=true&db=ccm&an=105273312&site=ehost-live6 Romero DV, Treston J, O'Sullivan AL. Hand-to-hand combat: Preventing MRSA...methicillin-resistant staphylococcus aureus. Nurse Pract. 2006;31(3):16-25. http://search.ebscohost.com/login.aspx?direct=true&db=ccm&an=106444249&site=ehost-live. Stefani S, Chung DR, Lindsay JA, et al. Meticillin-resistant staphylococcus aureus (MRSA): Global epidemiology and harmonisation of typing methods. International Journal of Antimicrobial Agents. 2012;39(4):273-282. http://www.sciencedirect.com/science/article/pii/s0924857911004687. doi: //doi.org/10.1016/j.ijantimicag.2011.09.030.