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Hi Michelle,
Great question – Hope this assists.
Aged care is not quite like the acute sector in regard to how we manage MRO.
Signage and precautions are only required if a resident is being isolated for an acute infection. As I’m sure you would agree – there is no benefit to using PPE in a resident’s room if the resident is mobilising around the facility – and we would not isolate a resident for the rest of their lives as a result of an MRO diagnosis.
The first question is – what is the organism and where is it? Precautions and signage are dependent on the risk and means of transmission.
For example:
If the organism is MRSA in a wound and the wound is covered with a dressing – the risk of transmission is low. The only time that contact precaution PPE would be required is when the wound was being dressed or if the dressing came down – at this time the wound is exposed, increasing the risk of transmission. Standard precautions remain consistently. No isolation and no signage required.
Another example:
If the organism is C. diff, but the resident is asymptomatic and the infection not acute – transmission risk is low – no isolation and standard precautions is all that is required. No signage.
If the resident has an active C. diff infection and is symptomatic – risk of transmission is higher – isolation required and standard, contact and droplet precautions are required. Signage to these transmission means is required.
Another example:
If the organism was VRE in the urine and the resident had active UTI symptoms – transmission risk is higher – isolation and standard and contact precautions would be require – increase to standard, contact and droplet if there is droplet risk. Signage in accordance with the transmission means would be required.
If a resident is identified to be colonised with an MRO – transmission risk is low. Isolation is not required, transmission precautions are not required, and signage is not required. Standard precautions remain consistently.
For example:
MRSA located groin or armpit – no signs of active infection.
Agree – Using symbols can be confusing to those not aware of their meaning – i.e. agency or new staff. Using the correct transmission signage is the safest way forward on the door.
Infectious rooms requiring daily clean can be made known to the cleaning staff at the commencement of shift – understanding that these rooms are cleaned last and with TGA approved neutral and disinfectant product.
Feel free to keep the discussion going.
Kind regards Carrie