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date: 2012 CONTENTS Page Introduction 1. Screening 1.1. Screen swabs/specimens 2.0 Screening regimens for different patient groups 2.1 Elective admissions 2.2 Emergency and other admissions 2.3 Patients not included in mandatory screening 2.4 High risk patient screening 3.0 When not to screen 4.0 MRSA M,C&S culture test 5.0 Rapid MRSA test by PCR 5.1 Objective 5.2 Inclusion criteria for rapid screening 5.3 Pathway 5.4 Inter-hospital transfers 6.0 Known MRSA positive patients 7.0 MRSA contact screening 8.0 Newly identified MRSA positive patients – in-patients 8.1 Notification of positive MRSA status 8.2 Ward Doctor and Sister responsibilities 8.3 Nurse in Charge responsibilities 9 Newly identified MRSA positive patients – pre admission/out-patients 10 VISA/GISA/GRSA contact screening 11 Pre-operative screening Elective orthopaedic ward admissions 12 Transfers to other healthcare settings 13 Discharge screening 14 ITU screening and decolonisation 15 Renal unit screening 15.1 Haemodialysis patients 15.2 Satellite units 16 Staff screening 16.1 Introduction 16.2 Pathway 16.3 H&WC policy 17 References 2 2 2 2 2 2 3 3 3 3 3 3 4 4 5 5 5 5 5 5 5 5 5 6 6 6 6 7 8 9 10 10 11 12 12 15 ICT Infection control committee
IPC Manual/IPC protocol for MRSA screening
uk/en/Publicationsandstatistics/Lettersandcirculars/Professionalletters/Chiefmedicalofficerletters/DH_063138 MRSA screening . . 2. Monitor and DH in assuring and supporting the delivery of MRSA screening. All elective admissions must be screened.gov. all elective admissions must be screened for MSRA in line with Department of Health guidance… extended to cover emergency admissions as soon as possible and definitely no later than 2011.The roles of SHAs.gov.1 Elective admissions. The optimum time for those requiring decolonisation is for surgery to happen on day five of the decolonisation regimen.dh. Department of Health guidance published on Dec 31st 2008 clarifies: . . It does not prescribe how the NHS should deliver the commitment. eczematous skin lesions ( ref 1) Rapid MRSA testing by polymerase chain reaction. 1. dip swab briefly into transport medium prior to taking swab from the anterior nares of both nostrils. requires nose and perineal swabs only. or other invasive device site) Wound(s) swab. ensure swab from perineum rather than groin. (see below for more details) using red swab packs.Introduction ‘The Health and Social care Act (2008) Code of Practice for the NHS on the prevention and control of healthcare associated infections and related guidance4’ requires all NHS bodies to minimise the risk to patients. IPC Manual/IPC protocol for MRSA screening 2 .Operational guidance (July 2008) http://www. 1.1 Screening Screen swab/specimen requirements Nose swab. (including CVC site. Screening for MRSA and active decolonisation is a prime consideration in meeting these standards. http://www. CSU if catheterised.The assurances needed by trusts to provide evidence of MRSA screening. “Meeting the challenge of HCAI will require additional actions across the system… from April 2009.The planning requirements to support MRSA screening for all relevant patients from April 09. PCTs.” The following trust policy statements implement the guidance and mandates listed above and are part of the trusts “Managing patients with Meticillin resistant Staphylococcus aureus” (MRSA)” policy.e.uk/en/Publicationsandstatistics/Lettersandcirculars/Dearcolleagueletters/DH_092844 The guidance updates existing guidance but does not replace it. Gently insert swab into anterior nares (just inside the nostril) perform circular movement x3 and repeat in other nostril. (PCR).“Screening for MRSA colonisation: a strategy for NHS Trusts: a summary of best practice” (2006) http://www. which is a matter for local determination.dh. Screening is preferable in pre-admission clinic or two weeks prior to admission to allow test results to confirm if MRSA is identified and appropriate decolonisation regimen to be commenced.dh. -Other i. Perineum swab. Screening is mandatory on admission day if no clear screen is available within the preceding week. Screening regimens for different patient groups 2.gov. IV infusion site swab.uk/en/Publicationsandstatistics/Lettersandcirculars/Dearcolleagueletters/DH_086687 The commitment in the 2008/09 and subsequent 2009/10 Operating Frameworks to introduce MRSA screening state. Existing guidance includes: .
4) Day case ophthalmology Day case dental Day case Endoscopy Minor dermatology procedures.C&S culture test All MRSA screens should be sent for culture (M.4 High risk patient screening. (Please see exclusion list below) All emergency and other non-elective admissions must be screened on the day of admission. Rapid testing is specifically for timely reporting where there is a high risk of colonisation.4) 5 Rapid MRSA testing by PCR. unless surgery or treatment is planned within 24 hours.4) 2.3 Patients not included in mandatory screening (unless high risk as per 2.2 Emergency and all other admissions.transfers from another ward. Fucidin. Screens should be sent for culture. Routine MRSA screening should still be done by culture (MC&S). 4 MRSA M.C&S) unless surgery or treatment is planned within 24 hours.transfers into and from ITU. .2. not rapid testing. Rifampicin. not rapid testing. NICU because of size or known complication risk factors. or the patient is in the high risk category below (2. but are not already know to be colonised with MRSA 3 When not to screen During topical decolonisation regimen and for 2 days after.transfers from other hospitals. with antibiotics to which the MRSA is sensitive: (Excepting routine periodic ITU screening) Glycopeptides – Teicoplanin or Vancomycin. high risk of complications in the baby. Trimethoprim and Doxycycline. Sending routine screens for rapid testing that are not necessary delays urgent test result reporting.transfers from nursing/residential homes Culture is sufficient for patients who have been in any hospital within the last 12 months. unless surgery or treatment is planned within one week. and for 2 days after completing treatment. e.ie.Screens should be sent for culture. 5.1 Objectives Increase availability of side rooms Reduce risk for contacts Reduce bed blocking caused by waiting for MRSA screen results in ‘contacts’ IPC Manual/IPC protocol for MRSA screening 3 . or the patient is in the high risk category below (2. During treatment.4) 2. or the patient is in the high risk category below (4. . warts or other liquid nitrogen applications Children/paediatrics (unless in high risk group) Maternity/obstetrics except for elective caesareans . eg. Linezolid. The following patients require rapid screening to ensure they are MRSA clear due to the higher risks for MRSA acquisition in the following circumstances: . 2.g likely to need SCBU. .
Tick the appropriate box on the pack form indicating the reason for the rapid testing and request on Cerner as usual. request MRSA screen as usual on the request form in the red swab. please request separately on Cerner as they will not be part of rapid testing scheme.00 on weekdays and 09. For all other results for rapid MRSA testing. For rapid testing on nose and perineal swabs. A first positive PCR result (or Reactive report) will be reported to the ward. Positive tests for newly identified MRSA patients will be phoned to the ward.g from St Elsewhere. with appropriate actions discussed. Testing will take place at 09. or a positive culture. Inform infection control team on bleeps 2039 or 1576 within hours and extension 35216 during the week (leave a message on the answer phone). From 4pm Friday until 8. If rapid testing is wanted on a patient not in one of the categories on the pack form. rapid screening pack. Allow at least 2 hours from the time the test is run. Using the MRSA Rapid Screen Pack. Patients who are known MRSA positive in the past who are waiting for a third clear screen. wards will need to request by ringing extension 35216. Identify why the patient requires a screen. and write RAPID TESTING on form. so please confirm all rapid testing results in this way.30 on weekends/bank holidays. IPC Manual/IPC protocol for MRSA screening 4 . this request should be discussed with an IPC nurse. 5. sputum etc will not be part of rapid testing but will be processed as clinical samples/swabs as usual). e. If other swabs/samples are being sent. All ITU patients on admission to ITU All renal patients on admission to a renal bed.2 Inclusion criteria for rapid screening The following patients must be screened. 5.Improve evidence that patients are admitted with MRSA Improve flexibility for inter hospital transfers particularly emergency tertiary referrals and transplants.g.3 Pathway The infection prevention and control nurses keep a central list of patients who are being screened. Deliver the swabs to fridge on microbiology corridor as usual. All patients from care homes on admission All inter hospital transfers on admission All patients who are contacts of a newly identified MRSA positive patient sharing the same bay. this will ensure they go on the same run of testing. in contact bay please batch swabs together. If more than one patient requires a screen e. but confirmation is required by a second PCR result. Results may take some time to appear on the computer.30 and 14. or the microbiologist on call out of hours. not regular dialysis attenders who have their own screening schedule. take nose & perineal swabs (wounds.30 am Monday contact site manager on bleep 1112.
A screen for know GRSA patients includes: IPC Manual/IPC protocol for MRSA screening 5 . The IPC patient liaison nurse will also be available to assist with notification and to discuss on a case-by-case basis. e) The doctor should review any antibiotic therapy and modify as necessary following discussion with a microbiologist. isolation may be discontinued in liaison with the IPC team. The IPC patient liaison nurse will be able to provide advice and facilitate this.2.1. or member of the IPC team will notify the appropriate ward doctor and the nurse in charge of the ward of a newly identified patient with MRSA. or glycopeptide resistance indicates a broader antibiotic resistance pattern than MRSA. enhanced screening is needed for contacts of known GRSA patients. doctors. Decolonisation packs must be given as above. Notification of positive MRSA status A microbiologist.in-patients 8. The nurse in charge is responsible for: a) Ensuring isolation of positive patients in liaison with the bed manager. 8. (VRSA/GRSA or VISA/GISA) contact screening. b) Informing the patient of MRSA status and what this means to them individually with regard to isolation.5.4 Inter-hospital transfers If there are no available side rooms and the patient has no other infectious organism then patients from external hospitals may be admitted to open bays and screened on admission. preferably pre-admission. 8. This may be by PCR.pre-admission/out-patients Out-patients and pre-admission patients identified with MRSA must be informed by the staff who arranged for the screening to occur. Once a patient has 3 clear complete sets of screens. or where this is not possible. The ward doctor and ward sister/charge nurse are responsible for : a) Informing all staff who are involved in patient care: nurses. site manager and infection prevention and control. For this reason. each set 1 week apart. ONE complete set of swabs as described above is needed for clearance.3. Vancomycin. treatment (or not). nursing and medical students. Providing they are isolated immediately if a positive result is received the bay will NOT become a contact bay. b) Arranging ‘rapid’ screening (PCR) of direct contacts i. domestic and works department staff who have contact with the patient of isolation precautions. 6 Known MRSA positive patients Screen on admission and discuss further screening frequency with infection prevention and control team. on admission. family. other patients in the same bay.e. 9 Newly identified MRSA positive patients. 8 Newly identified MRSA positive patients. discharge planning and any other relevant issue as raised by the patient. c) Explaining isolation procedures to portering. d) Commencing topical decolonisation once agreed with IPC team. c) Arranging terminal clean and curtain change of the patients’ bed space. 10 Vancomycin or glycopeptide intermediate or resistant Staphylococcus aureus. therapists. 7 MRSA contact screening All patients who are contacts of known MRSA patients.
Ideally screening of all elective surgical admissions would reduce the risk of MRSA infection in post-operative wounds. This should be documented on transfer documents as well as any verbal ‘hand-over’. NW9 5EQ Tel 020 8200 4400 Fax 020 8200 7868 13 Discharge screening Discharge screening of MRSA patients should only be done: i. or managed on the elective orthopaedic ward. the infectious status of any patient must be declared before transfer to any NHS or ‘other’ healthcare facility. However. IPC Manual/IPC protocol for MRSA screening 6 . Difficulties with individual homes should be discussed with the Health Protection Agency: “REACTIVE DESK” Health Protection Agency Centre for Infections 61 Colindale Avenue. This may be by PCR if surgery is imminent.Prior to surgery for any patient who is scheduled for surgery but is already an in-patient. in order for the receiving trust to prepare adequate isolation or infection control precautions. NHS homes must be guided by department of health policy. ii. If a known MRSA patient has not been screened within the last week.Nose Axilla Perineum Skin lesions Wounds/ invasive device sites. nursing or residential home requests it prior to transfer. Transfers to other NHS bodies or to other healthcare facilities.On admission for emergencies .uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/D H_4009587 Although private homes may refuse any patient according to their own policies. including nursing and residential care homes. including MRSA status. The following Department of Health guidance is very clear: “There is no justification for discriminating against people who have MRSA by refusing them admission to a nursing or residential home or by treating them differently from other residents” http://www. The elective orthopaedic ward MRSA positive patients are not to be admitted. London. NB. Staff screening for GISA/GRSA discussed in staff screening section (Section 9) Pre-operative screening. allowing for an elective ward where patients are screened pre-admission. Patients should not be screened if they are on topical decolonisation protocol.dh.Preferably in pre-assessment clinic. There are two wards for orthopaedic care in the trust. or by culture for a surgery date one week or more in the future. . . 11 12 There are sometimes concerns from nursing and residential homes about accepting patients back from the trust once they have been identified with MRSA. or at least one week prior to admission for elective surgical admissions. Screening prior to discharge is not routine.gov. If the hospital.
Those not known to be MRSA go to a side room on non-endemic wards or Go to any appropriate bed on endemic wards if they have no known resistant organism / infection (not 5 bed bay). On transfer to endemic ward open bays.2% q. Continue protocol for 2 weeks or until patient leaves ITU. 2039. A risk assessment should be performed and documented by the critical care unit in these cases. When Intensive Therapy Unit Level 3 does not have MRSA patients. all transfers out can go to any appropriate bed on the receiving ward. Do not dilute. Apply to wash cloth and use daily directly as skin wash / bed bath. perineum. It is understood that there are limited isolation facilities and sometimes clinical need means that isolation of patients with infectious/transmissible organisms may not occur.d. Initiate decolonization regimen for MRSA positive patients Mupirocin in paraffin base t. whichever is sooner. (Hibitane used if isolate is resistant to mupirocin or if mupirocin is unavailable) Chlorhexidine mouthwash 0. Document reasons for not using protocol IPC Manual/IPC protocol for MRSA screening 7 . wounds. transfers out are as follows: Known MRSA patients go to a side room or designated cohort in endemic and non.) Isolate known positive MRSA patients. or 1991. (Nose. A risk assessment may also be needed to prioritise the use of isolation facilities for patients with the most virulent or transmissible organisms first. ● ● - ● ● ITU MRSA Screening and topical decolonization programme . go to any appropriate bed on endemic wards if they have no known resistant organism /infection (not 5 bed bay). Intensive therapy unit / critical care Admissions ● ● Known MRSA patients requiring a critical care bed should be transferred to Intensive Therapy Unit Level 4 rather than to Intensive Therapy Unit Level 3. Chlorhexidine 4% skin cleanser used as shampoo every 2-3 days. MRSA positive patients on ITU3 to be transferred to ITU4.d. to both nostrils. When Intensive Therapy Unit Level 3 does have MRSA patients. All patients with a known infectious or transmissible organism will have effective infection control measures put in place. Following completion of protocol discuss with the Infection Prevention and Control Team. All MRSA positive patients leaving the unit transfer to isolation side rooms or identified MRSA cohorts in non-endemic wards. Transfers out of Intensive Therapy Unit Level 4 not known to be colonised with MRSA or other resistant organisms: go to side rooms on non-endemic wards.s. and IV cannula sites and sputum / endotracheal aspirate.14.This protocol applies to ITU only Screen all patients on admission to ITU for MRSA.endemic wards.s applied as mouth care using pink sponges from oral care pack Chlorhexidine 4% skin cleanser. ‘rapid’ MRSA testing must be done immediately. Contact bleep 1576. CSU.
1 Staphylococcus aureus decolonisation in haemodialysis patients.15 Renal unit 15. See over-page IPC Manual/IPC protocol for MRSA screening 8 .
Dialysis units New transfers in from other Trusts Result = Staph aureus isolated Result = aureus No Staph isolated Result = No Staph aureus isolated No Yes Do not give decolonisation Give decolonisation for 5 days Do not give decolonisation Result = Staph aureus isolated Result = No Staph aureus isolated Staph aureus screen: Nose swab Give decolonisation for 5 days. Mupirocin in paraffin base t. normal shampoo.d. for 5 days.10 East wards and renal outliers Patients admitted who are on dialysis Before insertion of line. starting day before insertion Do not give decolonisation MRSA screen: Nose swab Perineum swab IV line (exit) site swab Wound(s) swab (CSU if catheterised) Rest 2 days Then repeat screen If Staph aureus isolated from repeat screen give one further course of decolonisation Send next dialysis Staph aureus screen according to rota Rest 2 days Then repeat screen If Staph aureus isolated from repeat screen give one further course of decolonisation MRSA and Staph aureus decolonisation regimen MRSA and Staph aureus sensitive to mupirocin.s. 10 East wards and renal outliers All admissions including transfers from other wards On discharge for patients attending dialysis units. rinse. Chlorhexidine 4% skin wash / bed bath – daily for 5 days. Chlorhexidine mouthwash q.Staph aureus and MRSA decolonisation in haemodialysis and PD patients When to send Dialysis Staph aureus screens: Access clinic and Low clearance clinic Patients likely to require dialysis within 6 months Before access procedure 10 South. rinse. graft making a fistula or fistuloplasty Before discharge to dialysis unit Dialysis units All patients every three months according to schedule New and old patients accepted to unit Before transfer to another dialysis unit PD patients Send on every attendance in hospital When to send an MRSA screen Dialysis patients Dialysis Staph aureus screen sent from dialysis unit every 3 months according to rota Insertion of dialysis lines and grafts and PD catheters Has a Dialysis Staph aureus screen been sent in previous 3 months? Access clinic and Low clearance clinic All new referrals When attending after a hospital admission 10 South. Twice during the 5 days Staph aureus resistant to mupirocin As above using hibitane instead of mupirocin If 2 or more courses of decolonisation have been given in previous 12 months then discuss with Vicky Pang HNT infection control Nurse 07799623159 or Infection Control x35216 IPC Manual/IPC protocol for MRSA screening 9 . Regimen of Hibiscrub hairwash. to both nostrils for 5 days.s.d.
● ● When units have non-isolated MRSA patients. ● ● ● See 16. IPC MRSA screening policy 10 . 16 16.2 appendix A for Health and Work Centre policy. rather than transmission limited to a bay and is instigated by the Infection Prevention and Control Team. all transfers to the Royal Free site must be screened and go to side rooms in non-endemic wards.2 Renal dialysis satellite units. side rooms or open bays in endemic wards. which will be managed on a case by case basis with discussion between HWC and microbiology consultant.1 Staff screening. and be screened immediately. Patients transferred to these units from the Royal Free Site should be screened prior to transfer or immediately on transfer if this cannot be arranged. Staff contacts of known GRSA/GISA patients may have a more extended screening and decolonisation regimen.15. Units which do not have isolation facilities will transfer all MRSA patients to the Royal Free site for dialysis until screened clear of MRSA. usually following an Emergency Infection Prevention and Control Meeting. Introduction Staff screening is co-ordinated by the Health and Work Centre (HWC) Staff screening is only indicated if the pattern of cross infection indicates transmission to diffuse areas of ward.
Topical decolonisation as per protocol for 5 days started immediately. -Staff refrain from work until results of post decolonisation screen known. skin lesions. . .2 Staff screening/management pathway STAFF SCREENING First Screen .H&WC and IPC Doctor decide on case by case basis whether staff continue to refrain from work during this time.Nose -Skin lesions Negative Positive No further action . . .Re-screen 2 days after finishing decolonisation. throat. Negative Negative Positive Positive Nil further action Discuss case by case basis with H&WC and IPCT IPC MRSA screening policy 11 . Negative Positive .Topical decolonisation will not be routinely repeated.Screen nose. Negative Screen Positive Screen -Repeat topical decolonisation for a further 5 days -Re-screen 2 days after finishing decolonisation. .16. Other sites if indicated. Return to work Re-screen weekly until 3 negative screens.Systemic treatment will be discussed by H&WC and IPCD.Refrain from work for first 48 hours of decolonisation.
Transmission can be greatly reduced by adherence to basic infection control measures such as hand washing before and after contact with each patient and general environmental cleanliness. aureus have become resistant to many antibiotics and are known as MRSA strains. weekends and those not available at time of visit by H&WCNA can be screened. usually following an Emergency IPC Meeting Screening IPC will tell H&WC (by telephone and email) and the ward manager if a staff screen is needed. For those staff not available at the time of the H&WCNA visit. The ward/department manager is asked to keep H&WC informed of progress. OTs. wounds etc). they will be logged on the list. He/she will take nose swabs from all the staff involved and swabs from anyone with exposed skin lesions (eczema. Aureus are treatable with a wide range of antibiotics. Most strains of S. A copy of the list must remain with the ward/department manager so that staff working shifts. The co-ordinating H&WCNA will ask the ward sister to compile a list of all staff that need screening including domestics. A copy will also be kept in H&WC so that results can be logged and progress monitored.16. IPC MRSA screening policy 12 . Such screening is instigated by the IPC Team. including flucloxacillin and are know as MSSA. physios. and limited options for treatment of MRSA means that a concentrated effort is made in the hospital environment to contain MRSA and prevent cross infection. The occurrence of invasive infection. It may be necessary for the H&WCNA to contact him/her on a regular basis to keep information up to date. instructions are left with one or two nominated members of staff in order for them to complete the screen.3 Appendix A Royal Free Hampstead NHS Trust Health and Work centre MRSA Policy Staphylococcus aureus (S. especially in vulnerable patients. doctors etc An H&WCNA will visit the ward/department and start the screening process. rather than transmission limited to a bay. Some strains of S. MRSA is most commonly transmitted on the hands of health care workers and survives in dust. Staff screening is only requested if the pattern of cross infection indicates transmission to diffuse areas of a ward. The H&WCNA co-ordinating the screen must check that the ward staff have the correct forms for submitting swabs and know how to label the swabs correctly. such as bacteraemias in hospital patients who may be immunocompromised or have open wounds. by the site manager. they will be contacted by an H&WCNA or if out of normal office hours. MSSA and MRSA are equally pathogenic and have the potential to cause life threatening infections. As staff are swabbed. Many people live symptom free in the community with this organism. aureus) is a bacterium commonly colonising skin and mucous membranes. Staff may also come to the H&WC unit for their swabs if they prefer. Staff are informed that H&WC do not routinely inform them of negative results – in the event of a positive result. This is the procedure to be followed should the Infection Prevention and Control (IPC) Team ask for an MRSA screen of staff.
dip the swab into the transport medium and rotate the swab anti-clockwise five times in each nostril. rather than higher into the nasal cavity. the reason for this advice will not be disclosed by the Microbiologist to the site manager. IPC and microbiology will not contact the staff member apart from exceptional circumstances. Microbiology should contact H&WC on Monday morning (or the next working day) and inform them of the member of staff’s MRSA status. staff should be given an advice sheet and any questions discussed. An appointment should be given to them when they come for their prescription. They will typically be off work for the first 48 hours of treatment. They must leave the workplace immediately. Use a different swab for each lesion. Betadine/chlorhexadine gargle four times a day for five days Chorhexidine 4% skin wash/bath daily for five days Hibiscrub hairwash. All transport containers should be clearly marked with the site of the lesion. Twice during five days If a skin lesion is infected. each case will be considered on an individual basis. It may be necessary to contact staff at home or in the case of agency staff. To maintain confidentiality. Decolonisation Treatment If their nose swab is positive to MRSA. Positive results Contacting Staff During Normal Office Hours (09. three times a day for five days. The staff member should be asked to attend H&WC as soon as possible. The same swab is used for both nostrils. Monday to Friday excluding bank holidays) Positive results will be telephoned through to H&WC by Microbiology An H&WCNA will try to contact the member of staff directly in the event of a positive result. To take a swab from a skin lesion. Bank holidays and Weekends. to both nostrils. Every effort should be made to maintain confidentiality at all times. This should be discussed with the H&WC and with one of the infection prevention and control doctors. rinse. IPC MRSA screening policy 13 . The swab is only rotated in the anterior nares. To take a nose swab. On attending for prescriptions. they will be given a prescription for Mupiricin in Paraffin base. It is the responsibility of H&WC to arrange and oversee treatment of staff with MRSA. via their agency. They should inform their manager that they will be away from work from work for 48 hours and this should be recorded as ‘absence due to infection control’ rather than sickness absence. The person notifying the member of staff (site manager or senior nurse) should advise them to contact the on-call Consultant Microbiologist to discuss the reason why they are being sent off duty. rinse. dip the swab into the transport medium and pass gently over the lesion several times until exudate or shedding has been collected. normal shampoo.00. The on-call Consultant Microbiologist should notify the site manager (or the most senior nurse on duty) that the member of staff should refrain form work and report to H&WC on Monday morning (or next working day) for further advice and management. Out of Normal Office Hours. Allow two days following completion of this treatment before starting the post decolonisation screening programme.00 – 17.
CJ/DM Dec 2004 Updated in conjunction with infection control and microbiology March 2005 Update August 2009 IPC MRSA screening policy 14 . The H&WCNA coordinating the screen should remain in contact with the colonised staff member and remind them to attend for follow up swabs. Three post decolonisation treatment swabs are needed at weekly intervals.Post eradication treatment screening process The first post decolonisation swab must be taken in H&WC. Ideally. If any of the post decolonisation treatment swabs are positive. all three should be taken by an H&WCNA but if this is inconvenient for the staff member. they may arrange to have the swabs taken on the ward by the staff trained/designated to do so. further treatment will be needed and this should be discussed with one of the infection prevention and control consultants.
DOH (1996) Chief Medical Officer. Colour coding hospital cleaning materials and equipment.British Society for Antimicrobial Chemotherapy.17.10 January 2007. 3 2 1 NPSA – Safer practice notice 15. Methicillin Resistant Staphylococcus aureus in Community Settings. Guidelines for the control and prevention of methicillin resistant Staphylococcus aureus (MRSA) in healthcare facilities. Department of Health (2008) ‘The Health and Social care Act. Code of Practice for the NHS on the prevention and control of healthcare associated infections and related guidance’ 4 IPC MRSA screening policy 15 . the Hospital Infection Society and the Infection Control Nurses Association. References Working Party Report . Journal of Hospital Infection (2006) 63S : S1-S44.
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