Standard precautions trump scheduling with MRSA patients
Q: I am curious as to the scheduling of a known MRSA patient in the operating room (OR). Are there any regulations as to whether they should be done the first case of the day or the last?
A: Whether you schedule known MRSA patients in the OR first or last isn’t nearly as important as how your OR staff is trained.
There are no regulations or laws of which I am aware that require you to schedule a known MRSA patient for surgery at a certain point in the day. You should consider every OR patient potentially colonized with MRSA and consistently use standard precautions. In addition, CDC recommends the use of contact precautions for known or suspected MRSA in the acute care setting.
All OR cleaning and disinfection of the environment should be conducted the same in between every patient, regardless of whether that patient has a MRSA infection/colonization.
The fact is, there are many OR patients infected/colonized with MRSA that we don’t even know about. If staff members religiously follow the precautions noted above, whether or not there is a known patient infection/colonization, the time of the scheduled surgery is inconsequential.
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Libby Chinnes
Libby Chinnes, RN, BSN, CIC, owner of IC Solutions, LLC (Mt. Pleasant, SC) is an infection control consultant with more than 25 years of experience in infection prevention. She provides consultation to infection control programs in assessment and problem solving, and infection control training in acute care, long term care, ambulatory care, home care, and long term-acute care.
Libby has written 3 posts.
Comments
It has taken time but our surgical services have a protocol to utilize to implement contact precautions in our OR’s. Patients are scheduled in the last time slot. Terminal cleaning is performed when this is not possible and physicians don’t like their cases being delayed so this motivated them also to comply with this scheduling. Extra equipment is moved out of the OR, equipment unable to be moved is covered, cabinets are not opened. The circulator gowns and gloves and does not leave the room once the case has started. Contact precaution signage is posted on the surgical suite and not removed until EVS has cleaned. It can be done and this ultimately helps reduce the risks inherent with MRSA.
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