MRSA Contact Precautions Removal Algorithm

MRSA Positive Patient

(culture confirmed)

Check all that apply.

In the past 6 months the patient:

No testing
In the past three weeks,
indicated until
□ was an inpatient in any hospital has the patient had any Delay testing until three
no boxes are
form of an antibiotic weeks after all antibiotics and
checked. YES NO YES
□ has had a positive MRSA culture/ administered or skin antiseptic washes have been
infection or presumed repeat MRSA antiseptic used (e.g. CHG, discontinued.
Continue Contact
infections bleach bath)
Precautions

If the patient currently has an

Are either of the boxes checked? indwelling device ask family if
NO
either prescription or over the
counter topical antibiotics are
being used at the site of the
Begin MRSA surveillance cultures. Obtain 3 sets of device.
cultures using the order “Staph Screen”. Staph
Screens are to be done 7‐14 days apart. Staph
Screens to be ordered include:
1) anterior nares (one swab may be used
to culture both nares AND
While the patient is going through the testing
2) rectal swab if MRSA is from any site at
process, the patient must remain off all forms of
or below the waist or if original site is
antibiotics & refrain from bathing/showering with
unknown AND
antiseptic products. Use of antibiotics or
3) tracheal aspirate if patient has a tracheostomy
antiseptics will require re‐starting the process.
4) areas with rashes/dermatitis/eczema/wounds AND
5) entry site of any indwelling device that traverses
the skin (e.g. tracheostomy or gastrostomy)

No further testing indicated. Obtain 1st set of

Patient will remain on Contact Precautions. YES cultures. Are any
positive?
STOP HERE

NO

No further testing indicated. Obtain 2nd set of

Patient will remain on Contact Precautions. YES cultures. Are any
positive? Infection Prevention and Control
STOP HERE Director:
Office Phone: 668‐7230
NO Pager: 456‐6805
Email: barbara.stein@chkd.org

Practitioner:
No further testing indicated. Obtain 3rd set of Office Phone:668‐9908
Patient will remain on Contact Precautions. YES cultures. Are any Pager: 475‐4929
positive? Email: catherine.giagnacovo@chkd.org
STOP HERE
Fax: (757)668‐7566
NO

Contact Infection
Patient will remain on Contact Precautions Prevention and Control Infection Prevention & Control will
until all criteria are met. NO for review. YES remove patient from MRSA Contact
Precautions List
STOP HERE Are criteria all met?