McCleary MRSA Prevention

In the near future, the Maine Health and Human Services Committee will hear arguments for and against LD 267.  This is my proposal, sponsored by Representative Adam Goode of Bangor and 8 other cosponsors that will improve Patient Safety in Maine Hospitals.

MRSA is deadly.  It is easily spread in hospitals and in the community.  Both of the most common strains of MRSA, Hospital Acquired and Community Acquired are spread in hospitals and other health care facilities.  Both can cause deadly infections in the blood stream, lungs and other body parts and systems.  Health care workers, if not using the appropriate contact precautions, can carry MRSA on their hands and clothing and on medical equipment, from one patient and/or their surroundings, to another patient and/or their surroundings.   It is happening every day in Maine hospitals and without proper screening and precautions, it will continue to happen.

Ideally, every patient should be screened for MRSA on admission or within a couple weeks prior to admission, allowing for decolonization prior to admission and/or invasive procedures.  But, short of testing ALL patients, high risk screening is necessary.  LD 267 lists the most widely accepted list of high risk patient populations.

1. Patients who have been in a nursing home or hospital in the past year.

2. All ICU patients

3. Patients who have been in a prison in the past year.

4. Dialysis Patients

5. Patients getting surgical implants.  ie. knee replacements, hip replacements, cardiac valve replacements

6. Patients with open lesions with redness, swelling, and other signs of infection

7. Patients with known history of MRSA

This list includes not only patients who are at risk for being a carrier or “colonized” with MRSA, but also those who are at risk of becoming infected because of the procedures or departments they are facing when hospitalized and those who may already be infected.

CDC recommends isolation or cohorting patients all known  MRSA colonized or infected patients.  If a patients status is unknown, hospitals are not taking appropriate precautions.  Ignorance is not bliss when it comes to MRSA.  Ignorance is deadly when talking about MRSA.  It is imperative to know a patients MRSA status, in order to protect them (with decolonization) and to protect the patients they are roomed with.

The recent Maine MRSA prevalence study revealed that nursing home patients had an average of 20% prevalence of MRSA colonization.

http://www.mainequalityforum.gov/2011_Final_HAI.pdf

This is alarming.  Much of MRSA is coming from nursing home patients.  We need to screen every single new nursing home patient on admission to their nursing home.  Education needs to expand and be emphasized in long term care facilities.  Our elderly and disabled deserve better than they are getting.

I’ve heard repeatedly that MRSA “isn’t that big a problem” in Maine Hospitals.  “There aren’t that many patients with MRSA”.  That is a perspective.  Considering the thousands of patients going through our larger Maine medical systems every year, the number of MRSA vicitms may seem insignificant to hospital representatives.  But, ONE single MRSA victim is one too many. The Federal Health and Human Services Department and the Federal CDC implore Maine Hospitals to aim for ZERO.  There is no way to do that without using Active Detection and Isolation and without actually counting every single infection in our hospitals.  Then publicly report those cases.  Let the victims, patients and health care consumers decide what is a significant number of infections and what is not.

Please support Maine LD 267 to prevent MRSA.  And also support the right of all patients to have a patient advocate with them 24/7 with few exceptions.