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Hi Bec
The national infection control guidelines list these screening recommendations:
Patients at high risk of carriage:
— those who are known to have been previously infected or colonised with MRSA
— frequent re-admissions to any healthcare facility
— transfers from other acute care facility
— residence in long term care facilities
— patients with chronic wounds
— recent inpatients at hospitals known or likely to have a high prevalence of MRSA
— locales or populations where community-acquired strains of MRSA are prevalent
Patients in high-risk units
— ICU/high dependency unit (admission and discharge)
— Spinal unit
— Burns unit
— Pre-operative clinics
— Patients with planned prosthetic surgery (joint replacement, cardiothoracic surgery)
The AICA / ACSQHC guidelines suggest:
MRSA Recommended:
Patients with chronic wounds or indwelling medical device (not previously known to have MRSA)
Optional:
Dependent on locally demonstrated epidemiology of MRSA:
– Transfers from other acute or long term care facilities or readmission after recent prolonged hospital inpatient
care*
– Admission screening in locales or populations where community-acquired strains of MRSA are prevalent.
Specialised units including intensive care units
All patients on admission; then weekly or twice weekly dependent on demonstrated acquisition rates
Optional:
Selected preoperative patients
I would not be including patients just because they were long term in my facility unless they met one of the above criteria, or unless there was clear epidemiological evidence of local increased risk within your facility over a certain time frame.
As far as long term care facilities is concerned, my interpretation is actually any residential care with assisted care facilities. Not retirement villages with independent living. We do have residential care in our screening policy, but I am not sure how well it is followed currently. If you have any local epidemiological data on local residential care MRSA colonisation / infection rates, this could also be used to guide screening policy.
Good luck, always hard to know who to screen without wasting a lot of time and resources for little gain.
Cheers
Michael
Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3326 3523
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
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Good morning all,
I would love some feedback regarding the following:
1. What time frame does your facility define a patient as “long term” e.g. MRO risk
2. And with the Long term classification does your facility screen for MRO’s as part of surveillance??
Thanks, have a great day.
Rebecca O’Donnell | Infection Control Co-ordinator
St Vincent’s Hospital Toowoomba | 22-36 Scott Street TOOWOOMBA 4350
T 07 4690 4042 | F 07 46904400
E rebecca.o’donnell@stvincents.org.au | W http://www.stvincents.org.au
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