McCleary MRSA Prevention

Having gone through the process of the hospitalization, treatment, and eventual death of our father, it became obvious that big improvements were needed in the areas of screening/reporting of MRSA. My sister is leading the effort here in Maine to require hospitals to not only develop, but IMPLEMENT new policy to help control this life-altering and oftentimes life-taking infection. Please join her and a growing number of supporters in this fight to protect yourself, your loved ones, and your community.

I have put this webpage on the All Nurses forum online. I recently heard from a Maine EMT who is now also an RN. She stated that there is no education for EMTs about drug resistant organisms. I do believe they get education about Universal precautions, and that is part the education needed. But, a good infection control course for EMTs could help them to learn the importance of protecting their patients from cross contamination, and from contracting illnesses from patients themselves. Appropriate precautions and strict adherance to sanitizing ambulance equipment is very important in avoiding the spread of any disease.
I offered to talk with her group of EMTs and give what I have to offer in regards to MRSA infection control. It is interesting to me that my MRSA proposal in Maine has already opened up important conversations about prevention…..proactive approach instead of reactive approach.
I am very happy about that.

My husband Mike and I went to Augusta to work out the language in the legislative draft of my MRSA proposal today. Adam Goode D-Rep Bangor, is the ambitious young man who is my chief sponsor. He is a dedicated and hard working representative and he wants it to go well. We spent a half hour going line by line working to perfect the language in our first draft from the legislative writers.

Also at this meeting was BJ Hurlihy an organizer from Maine State Nurses Association. The support from MSNA is overwhelming. They have already worked out a strategy including gaining more support from other unions in the State and having a Legislative Day on May 2. They will speak about MRSA for 1 to 2 hours at that time. I will also be there to speak about my proposal. They are very active and supportive and I truly appreciate their work.

I am feeling confident that the more MRSA is discussed and the more dialog Maine citizens have about it, that an effective and organized approach to MRSA prevention will be welcomed. This is all about saving lives.

I will write updates as I go along and during the legislative process.

Greetings
I would first like to extend my sympathy for the loss of your loved one. Mr.Jonh P. McCleary was a handsome fellow. May his soul be at rest.
My mother did not die from MRSA but she did die from C-Diff. She went into the hospital November 1, 2008 with a partial hip replacement and she died December 4, 2008 from Clostridium Difficile (C-Dif). Just like you, my sisters and myself are planning to be advocates in the effort of informing and educating people about these deadly germs. I got your link from an article in the online March 2009 AARP Bulletin magazine. I do not as of yet have a website but please feel free to use my email address. I would truly like to speak with you and ask a few questions. Thanking you in advance.
Theodora

Greetings to all
I have just learned from an operating room nurse that I had a MRSA infection from a breast biopsy in 1994. The infection took six months to heal and went all the way to my chest wall. I was never told by the doctor or hospital that the infection was MRSA.
Patients need to ask “Is my infection MRSA?” and not stop until they get a complete answer.
Thank you, Kathy, for all the work you are doing. 26 states now require reporting MRSA infections. Maine is not one of them. This is unacceptable.

My name is Vivian and I am sorry for your lose..It is horrible to lose anyone but especially when it could be prevented..

I have MRSA Came out of a nursing home with it in my lungs…Called CA-MRSA..Went in for rehab to learn to rewalk after oxygen dropped to low..Never was I ever informed how others there might have something called MRSA nor did I know what it was..I am in TN and it seems to be rampant here with no end in sight..and I certainly have not had a well day since nor do I bleieve I ever will..Was treated with several antibitoics before ever cultured..It is so important to be cultured first and given medicine next..Several allergies later and nothing works on it for me..
It is fabulous that you are doing all this work..This is killing so many people every single day..No one seems to notice.

I understand your anger of losing your dad to an infection that he most likely acquired in a hospital and succombed to. I am puzzled about why the legislation to spend money, and health care workers limited time and resources on the broad based screening for MRSA colonization in so many patients that come in to the hospital.I feel this screening is not effective at decreasing the incidence of infection and is wasteful.

Staphylococcus Aureus is a microorganism that colonizes surfaces and people, those sick and well.Why screen the patients? These organisms have been a problem in hospitals for years, do you recognize that anyone working in the hospital could be colonized?? Doctors,surgeons, nurses, housekeepers, lab techs, dietary personal, I feel all these people have likely been exposed to MRSA in the hospital (and probably at their local grocery store.)These people are likely to have more close contact with a patient than another patient would.

I’m not advocating MRSA screening of anyone, especially healthcare personel.I feel the efforts should continue to be focused on good infection control practices,education and communication.

Erin Rumpf

@Erin Rumpf
I agree that good infection control practices, education and communications are very important in MRSA control. But, these things along with Handwashing campaigns to control MRSA have all been common practice for years and yet the rates of MRSA climbs every year. These things alone DO NOT WORK!!
Screening for MRSA is the only way to find out if a patient is colonized or infected on admission. If they are, the must be isolated or cohorted and NOT roomed with uninfected patients. This is one of the first tier recommendations of the CDC. Although this is fact, there is no way to find these patients who are colonized or infected without screening. Screening is not even addressed until the THIRD tier of the CDC recommendations for MRSA control.
It is true that there are healthcare workers and people in the grocery store that are colonized with MRSA. About 10 to 15% of all of us are colonized, but people in the grocery store and healthcare workers are NOT facing invasive procedures nor are they vulnerable to active infection unless they themselves go into the hospital or other healthcare facility where MRSA is commonplace. If a healthcare worker is colonized, it is unlikely he/she will spread infection if they follow good infection control. However if they become ill with a cough and sneeze, they may very well spread MRSA by droplet spread. Ill HC workers should not be caring for patients.
Screening is important on two levels.
1) If a patient is facing an invasive procedure such as surgery or central line placement, and they test positive for MRSA, they can be decolonized and their risk of active serious or deadly infection is decreased 7 fold. This is how screening is beneficial to the patient being screened.
2) If a patient screens positive, they must then be isolated or cohorted with another MRSA positive patient and contact or transmission based precautions must be used. This is how MRSA Screening is beneficial to other vulnerable hospital patients. MRSa positive patients must not be sharing facilities or equipment with non infected patients. If this is allowed to continue, we will never control MRSA.
It takes committment, intelligence, and determination to stop MRSA. It takes a multifaceted approach including screening, isolation, contact precautions, decolonization, decontamination and educatoin to stop MRSA. It has been done in numerous hospitals across the US, Europe and Canada. It can be done her in the US too.

@Erin Rumpf
May I add here Erin, that there is no question that my father acquired his MRSA in the hospital. He was in the hospital for 12 days for rehab for a very minor ankle fracture. He was home one and a half days when he collapsed with MRSA. He had no infiltrates in his lungs when he was admitted the first time and when he was readmitted he had MRSA pneumonia in the left upper lobe. Thanks to his small community hospital and their ineffectual non existant MRSA infection control. I blame the policy makers and IC educator at that hospital, not the nurses. His direct nursing care was incredible. And yes, I know that some of those hands may have brought him his MRSA. Without an effective and enforced policy, nurses are at a loss. Individual efforts are not useless but mostly ineffectual if there is no administrative support and policy.
Also, any money spent on MRSA prevention will come back and more. The cost to patients, hospitals and insurers for HA MRSA is phenominal. There has never been a successful MRSA Prevention program that has failed to pay for itself and in the end save the hospitals money.

Wow whim and wasteful? Come on. For everyone who thinks the same…..

Let me tell you about screening. Let me tell you about the newborn screen. Let me tell you about how a simple blood screen test, given at birth, saved my daughter from her life altering birth defect. Let me tell you about how Maine was a leader in the nation when they adopted this screening legislation. And this legislation didn’t just test randomly, it tested universally!! Let me tell you about how one simple drop of blood ELIMINATED a lifetime of doctor bills that YOU the public would have been paying for, and a lifetime of mental and physical disabilities that again, you the public, would have been paying for. Let me tell you how EFFECTIVE screening is. Let me tell you that in less than 48 hours, my daughter was screened, diagnosed, and on medication that SAVED her from her birth defect. Had this screening NOT been done or even delayed by one week, she would have suffered, both mentally and physically…and YOU would have had to pay for her lifetime. Birth defects have been around since the dawn of human life, but since the 1970′s, children born with my daughter’s same defect (and a whole host of other defects) now have had a chance to live a life, without any impairments. COUNTLESS children were saved!!! You think it is unnecessary and wasteful? You are clearly wrong. And let me also tell you about the wonderful people that did the screening, the lab work, the result analysis, the notification, and her Pediatrician, who stayed until after hours, waiting for me to call back. Let me be absolutely clear that these are the best of the best of our healthcare professionals….because they know how effective this screening is, how crucial the results are, and how precious time AND LIFE is.

While my daughter’s case is not life taking (like MRSA CAN be), it is life altering (like MRSA CAN be). The two screening issues are parallel. Screening is NOT wasteful, as you suggest. Sitting around, making statements that screening IS ineffective, is costing people their lives. And it’s bogus.

SCREENING SAVES LIVES. MRSA takes the lives of people more than AIDS, each year. MRSA screening will save patients’ lives and billions! Just like it did in my daughter’s case. This legislation was proposed with the highest regard for human life. ALL HUMAN LIFE. Please get all the facts by reading this web page more.

I ask you this…would you want to pay for a lifetime? or would you rather have a simple screen, covered by insurance, ELIMINATING those bills and reducing healthcare costs?? You probably wonder WHY health care is so expensive…don’t you.

And ask yourself one more question….if you went into the hospital for a minor injury or even a serious surgical procedure where you had to be placed in a room for a few days with someone who has MRSA…..are you really prepared, to gamble WITH YOUR LIFE, and take your chances of NOT acquiring MRSA?…..when you were completely healthy walking in the front door, but could quite possibly be wheeled out the back door into a waiting hearse? Go for it….but you are alone in that boat! What if YOU were the one spreading it around!!!??

Kathy has devoted a gazillion hours into research on MRSA and I would dare say she has become one of the nation’s leading experts on the subject. She has compliled a comprehensive approach to MRSA screening, detection, isolation….etc., in an effort to save lives, dedicated to that handsome, smiling face that appears on here….her father, and my father-in-law, John P. McCleary, Sr.

As for “understanding your anger and pain”….no, no, no, no, no, I don’t think you do. “Most likely acquired at the hospital and succumbed to….” This is fact, and you state it like it is just a theory. Barring anything else, my father-in-law would be alive today had it not been for acquring MRSA. THIS IS UNDISPUTABLE FACT. While freedom of speech and commenting on a website is well within one’s right, I ask that you please get educated by reading this ENTIRE website before making off the wall comments like those!

I am so proud to have Carol as my sister in law. She has dealt with the threat of a disabling birth defect in her precious daughter were in not for a simple screening test at birth. I remember when she came to my house from northern Maine with her precious baby girl, who was less than a week old. She was seeing a pediatric specialist here in Bangor, for her daughter’s birth defect. It was so difficult and so frightening, but she and my brother handled it with diligence and determination. Their beautiful daughter who is as healthy as a horse today because of early detection, is proof of her parents boundless love and determination. And she is healthy because somebody had the determination to make birth screening mandatory nationwide……for everybody’s babies.
I hope to help make everybody who goes into a hospital, here in Maine and nationwide safer because of a simple MRSA screening test.
Thank you Carol for your powerful letter.

I was a little 2 YR old girl in 1967 that came into the hospital for 2nd and 3rd degree burns on her legs. After spending 3 months in the hospital I was infected with Hepatitis B, from a blood transfusion, and chicken pox from a child that was admitted to to the hospital (big mistake) I survived my ordeal and am lucky Mrsa was not an issue at the time.

I am all for preventing MRSA from infecting people!
I would like to see infection control practices of staff, patients and visitors be inproved!

I’m a clinical microbiologist and would say Staphyloccus Aureus (for those who aren’t familar the SA in MRSA) causes ballpark 80-90% of infections that are cultured.

Staph Aureus is possibly everywhere a hand might touch…….

Phone
keyboard
mouse
chart
bed rail
counter
door knob
floor
pen
grocery cart
clipboard…etc

So it’s on alot of peoples hands….who than touch other stuff…including their own face, nose, baby……. and in the case of my preteen her scabs and pimples etc…….

I’ve just seen that the screening presently being done is not decreasing the the amount of positive cultures I see…..but don’t have all the facts!

I too have had a parent who became colonized with a chronic pseudomomas infection after a surgical procedure….he has lived with it, been treated with BIG GUN antibiotics but is diabetic and been hospitalized many times this year so I feel he also has a major predispositon for more DRO”s ( Drug resistant Organisms)

Erin,
I am sorry for your troubles in the past and for your parent’s medical struggle with a hospital acquired infection. I know by personal experience what you are going through.
Think about your getting Hep B. Because of stricter standards and new military like check points for a pint of blood these days, it is almost impossible for a contaminated pint of blood to pass through the blood donor system. This is a type of screening. Bloodborne pathogens used to be a risk in the 60s when you got a transfusion, but it is highly unlikely now.
This is why we need screening and standards. I am not suprised you are seeing as much or more staph cultures in your work. Most hospital are testing and screening more. My studies have shown me that approximately 30 to 40% of the general public has staph and approximately 5 to 15 percent have MRSA. This is probably not 100% correct, but it is pretty close.
It is important for all of us who may be at higher risk for contracting an active MRSA infection to be screened. This allows us the advantage of getting decolonized prior to surgery or another invasive procedure, such having a central line placement or gastric tube placed. Decolonization or “interruption of MRSA” as some prefer to call it, greatly reduces our risk for invasive and possibly deadly disease. The screening test is cheap and harmless, but it has immeasurable value.

Yes, MRSA and SA are all around us. Handwashing is extremely valuable in prevention, but it is not a silver bullet. MRSA screening and the resulting awareness and proactive prevention is absolutely necessary in the prevention of crippling and deadly MRSA infections.

@Kathy
Hi, Kathy. It seems unbelieveble that MRSA detection has not been mandated. I am meeting with the principals of a company that purportedly has a composition [cost effective treatment]that will prevent and / or eliminate MRSA bacteria. From what I have read, if there is no standard to comply to, it seems hospitals, nursing homes, rehab centers, etc. will have no sense of urgency to use such a solution. I would appreciate your emailing me so I can learn more about what is / is not going on to legislate testing / screening / prevention of MRSA. My email is plester111@gmail.com Thank you, Kathy.

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I was a hospice nurse when I acquired a MRSA infection in my face. Having survived pituitary surgery for Cushing’s disease and double mastectomy for cancer I was closest to death with a MRSA infection. I was immediately started on treatment as I went to the ER in the early morning hours. Having gone to bed with no sign of infection in my chin to awake with pain and swelling, sending me immediately to the ER I was begun on oral antibiotics The next morning I presented to work at the hospice main office – to show my face that was very swollen and to express my need to go again to seek medical help. I was seen at the urgent care near my work and told that the original RX was half the dose required for MRSA and was started immediately on the higher dose and given pain medication. The following day I was worse and returned to that clinic, I was given an antibiotic injection and sent to the university hospital ER to see a facial surgeon to get his consult for possible need to open the infection to facilite the healing. After waiting for 12 hours in the ER again I was seen, MRSA was diagnosed by blood cultures and skin cultures IV antibiotics were started and I was kept in the ER room for I believe 2 days and then taken into issolation at that hospital for a total stay of 5 days. During that stay my liver was not tolerating the antibiotics and the third antibiotic was started and one of the original 2 was stopped. I lay in bed knowing that if this did not work I might not get over this. I was discharged with 2 forms of IV antibiotics, which I hung myself with the assistance of homehealth to start the original site and when necessary move the IV site. I was on this for 10 days then spiked a fever only 24 hours later and therefore, was treated for 10 more days. The infectious disease physician that did my followup care supported my belief that I was exposed to MRSA from the patient that I had cared for in a nursing home. He supported this with information sent to workman’s comp insurance. I will write more about my journey soon and my goals to see this problem eliminated.

Thank you for this web site (I found today.) Dealing with MRSA (Hospital Aquired) in 2012-13 has totally caused multiple changes in my life. Long recoveries, 4 head operations, medications that did not respond to MRSA, complications from surgery, pain, costs of medical bills, unable to now meet living expenses and loss of job. On the positive side I am alive.

Currently I am hoping that I willl not be having anymore head surgeries. Being a nurse does not make it any more uncomplicated. Mentally I am more sensitive to people with life treatening health issues /disabilities and the need to continue with preventing MRSA

To reduce MRSA my suggestions are as follows;
Handwashing and Sterile Dressing Changes are essential. (this did not always happen)
Review and revise when to obtain cultures standard for MRSA as needed
Require all health care providers wno deal MRSA know the current Rx and dose as well as length of time (CDC Standards of Care)
Questions// Are all EMT’s being educated each year on MRSA in Maine?

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