Course Access
Hi Barbara
We are currently taking a risk assessment approach in the prioritisation for single room accommodation for contact precautions. We have both VRE faecium van B and VRE faecium van A (resistant to Teicoplanin), as in other facilities we believe that VRE van B is now endemic within our facilities, where as VRE van A is not endemic and therefore we prioritise single room accommodation for this type. As when VRE van B was the “new-kid-on-the-block” and strict contact precautions and “isolation” was implemented in an effort to prevent transmission and endemicity, we are now taking this approach with van A.
We would also prioritise MRSA over VRE van B as it is associated with higher morbidity and mortality rates.
As previous mentioned in previous responses we would certainly prefer patients colonised with VRE van B with diarrhoea to be accommodated in a single room.
We do have an evidence-based VRE clearance protocol which we have been offering to patients for a number of years with varying degrees of success. For the most part patients a very appreciative of the opportunity to try and have the stigma of a resistant organism alert connected forever to their name.
In our facility we are working with all HCWs to understand that, for the most part, it is our actions or omissions that result in the transmission of multi-resistant organisms. Missing hand hygiene moments, not cleaning equipment between patients, not providing hand hygiene opportunities for our patients, not maintaining a clean environment. When these simple activities are not adhered to in general (often before we are aware of an MRO result), placing a brick wall between the HCW and the patient doesn’t necessarily increase compliance.
In short, single room accommodation for VRE van B is not a priority in our facility.
Beth
Beth Bint
Infection Prevention and Control Clinical Nurse Consultant | Infection Management and Control Service
Level 1 Lawson House Wollongong Hospital
Tel 02 4222 5898 |beth.bint@SESIAHS.HEALTH.NSW.GOV.AU
http://www.health.nsw.gov.au
________________________________
Hello,
My managers have asked me to review our current practices of isolating VRE positive patients. This is mainly due to the limited number of single rooms within our facility. I am interested to know how you manage patients who have a positive VRE screen, whether you isolate or not, what risk assessments you undertake to determine as to whether to isolate or not and whether you have introduced a yoghurt regime for these patients and how you then manage these patients.
Thanking you in advance,
Barbara
Barbara May
CNC Infection Control
Hastings Macleay Clinical Network
Ph. 0255242061
Mo. 0402890677
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