Question

Your patient has been undergoing outpatient treatment for leukemia and was hospitalized in the critical care unit last week with pneumonia and respiratory failure. His pneumonia was diagnosed as community-acquired MRSA. He was transferred to your oncology floor 2 days ago. Before you enter the room, you perform hand hygiene and don an isolation gown, gloves, and a mask. As you enter the room, your patient says, “Finally, someone comes in here. I feel like an alien, and you are dressed like one.”  

   1.   How do Contact Precautions differ from Standard Precautions?

   2.   Identify reasons staff members may want to avoid taking care of this patient or entering his room.

   3.   Reflect on possible ways to respond to this patient. What are his concerns? What might he be feeling? How might you communicate with him considering these things?

   4.   Decide how you will talk with other members of the healthcare team about the patient’s observation and concerns. Explore possible ways to approach the subject with other staff members.

Answer 1

1. When standard precautions alone are not useful in preventing spread of pathogen or infectious agent then contact precautions are useful.

Standard precautions are minimum infection prevention and control practices that must be fallowed by every person in any situation.

2. Patient is suffering from community aquired MRSA( methicillin resistant staphylococcus aureus) It causes serious skin infection or it can infect deep wounds. If bacteria from skin enter into bloodstream, it cause major problems like infection of heart valves, lungs, bones or joints. Most important thing which one cannot neglect is MRSA is very contagious and spread through direct contact with patient and patient has pneumonia also. These are may be resons due to staff members are hesitating entering his room.

3. MRSA can be treated. There are some antibiotics that kill MRSA germs. So health care provider should wear mask, gawn and hand gloves before entering the room of patient. Disinfect hands properly with alcohol based sanitizer before and after treating patient. Patient is in isolation room so he might be feeling lonely and get bored. He needs proper care and communication. His lonliness may cause negative psychological impact on him. So to prevent this, health care providers must allow him to use radio or ear phones or arrange tv in his room so that he can enjoy and feel comfortable.

4. From patient's observation nurse will came to know patient is recovering or not. If there is no effect of antibiotic seen nurse should talk with staff members or team and doctor so as to change antibiotic. And if nurse observed that infection is spread throughout the body then patient needs surgery to drain out the infection. So nurse should have talk with doctor and team regarding this.