MAINE LD 267 FOR 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.
I continue to be amazed at the work you are doing Kathy. From your perch in a small town in Maine, your message is getting through loud and clear: That the reason that the US healthcare system hasn’t gotten MRSA under control and it has now spread beyond hospital walls is becoming very obvious…..Hospitals are failing to identify who is carrying it into their facilities and who is leaving with it. And the reason they’re not doing this is because the organizations that provide standards for them to follow have failed to include patient MRSA screening and isolation as a necessary step in controlling it.
All healthcare workers in US hospitals are required to be screened for tuberculosis (TB). And all TB cases must be reported to the CDC. The CDC reports that there were 544 deaths from TB in 2009.
In contrast, the CDC reports that: “between 1999 through 2005, the estimated number of S. aureus–related hospitalizations increased 62%, from 294,570 to 477,927, and the estimated number of MRSA-related hospitalizations more than doubled, from 127,036 to 278,203. Our findings suggest that S. aureus and MRSA should be considered a national priority for disease control.” The latest estimates are that 19,000 die of MRSA, and 90,000 die of all healthcare acquired infections.”
Yet, patients and healthcare workers are carrying MRSA into hospitals every day and there is no requirement to screen or track the number of MRSA cases. It’s not even required to be disclosed on death certificates as a cause of death so we have no idea how many are actually dying form MRSA. National estimates of 19,000 patients/year is most definitely a gross underestimate and most, if not all of these deaths are COMPLETELY PREVENTABLE if adequate prevention methods are implemented. The VA health care system has decreased their MRSA rates significantly (and therefore decreased harm and death to patients) by implementing screening and isolation of all patients. Why aren’t all US hospitals REQUIRED to implement this system? (here’s a link to the details:http://patientsafetyauthority.org/ADVISORIES/AdvisoryLibrary/2009/Mar6(1)/Pages/27.aspx)
We are hearing about cases here in NH of MRSA being spread around by home health agency workers from patient-to-patient. These are patients that picked it up in the hospital and brought it home without any teaching about prevention or how to speak up to home health workers about using gloves, good handwashing, etc. (80% of active MRSA infections are healthcare-acquired)
We are failing patients in the US by not requiring MRSA screening, tracking, reporting and hefty fines for hospitals with high MRSA or infection rates.
What can we do to get healthcare standards and oversight agencies to put the safety of patients first?