Course Access
Hi Tim,
In reply to your message, Ive already posted a message through the AICA list.
All environmental surfaces that come into direct contact or indirect contact with the patient should be cleaned in between each patient. So with non-MRO patients this should be a neutral detergent and with MRO’s an appropriate disinfectant.
Yes you should clean appropriately in between each patient with the same MRO strain and the reason for this is the patient will have other flora that is unknown to the HCW. They could have other MRO’s. So the environment/equipment must be cleaned with the appropriate solution.
Regards
Louisa
>>> Tim Spencer 23/08/2012 8:49 am >>>
Hi Michael,
I find this interesting also.
I use a procedureal area for CVAD insertion, seeing up to 5-8 patients a day.
Quite often, these have an MRO (incl VRE) and I often see these patients towards the end of the day after the ‘non-infectious’ patients.
50% of my patients are immuno-compromised and so I triage my requests lists based around immune and infection status.
Between non-infectious patietns, we don’t get regular decontamination done, however do so after each MRO patient.
What I’d like to know is it necessary to decontaminate betwween patietns who have the same strain of MRO?
My procedureal bay is a large isolation room in our ICU that is NOT used for anythign except my procedures.
I get our after hours cleaner to do the room at the end of the day also.
Interested in hearing peoples thoughts on this also.
Regards,
Tim..
Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant | Central Venous Access & Parenteral Nutrition Service
Conjoint Lecturer, University of NSW
Dept of Intensive Care, Level 2, Clinical Building, Liverpool Hospital, Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel 02 8738 3603 | Fax 02 8738 3551 | Mob 0409 463 428 | Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au
—–Original Message—–
Hi all
Just trying to see what the current thoughts are in regard to management of patients with multi resistant organisms in procedural areas. Do most facilities still have ‘special cleaning’ after procedures on patients colonised or infected with MRSA, ESBL and MRGN’s? I would assume that most facilities would still have special cleaning following procedures on patients colonised or infected with VRE.
In my opinion, provided we have a good process for cleaning the immediate environment between cases, ‘special cleaning’ for MRSA / ESBL / MRGN is not necessary, and these organisms should be easily removed with normal cleaning techniques. The opportunities for widespread environmental colonisation from patients in procedural areas where patient movement is severely controlled is reasonably low, unlike in ward accommodation situations. VRE as an environmentally hardy organism requires a different approach, however. Does anyone else use this approach?
Also, should all MRO patients always be placed last on a list?
Any expert opinions out there?
Thanks
Michael
Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3326 3523
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
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