MRSA Screening Policy
Screening of all elective admissions was introduced by the Department of Health in April 2009 and screening of all emergency admissions will be required by December 2010.
Aim
The screening of patients will identify MRSA carriers either before or on admission. This will allow measures to be put in place to reduce the risk of infection for these patients and to other vulnerable patients in hospital.
Elective admissions
Elective admissions, including Day Surgery patients, are screened for MRSA, either at the time of admission or, for those attending pre-admission clinics, before admission.
The following groups do not need to be routinely screened as per the Dept of Health Operational Guidance:
- Day case ophthalmology
- Day case dental
- Day case endoscopy
- Children/paediatrics unless already in a high risk group
- Maternity/Obstetrics except for elective caesareans and any high risk cases.
Emergency admissions
Adult patients admitted as an emergency are screened on admission. Children/paediatrics are not screened unless in a high risk group, identified through the MRSA risk assessment.
Screening sites
Patients will undergo an MRSA risk assessment in pre-admission clinic or on admission. This will identify the body sites to be screened. Patients with no risks will have a nose swab only. Any patients identified as high risk will have nose and groin swabs plus any wounds/lesions. Any patient with a urinary catheter will be required to provide a urine specimen.
Treatment
Only a very small number of the total patients screened will be identified as being MRSA carriers. These patients will be offered treatment to suppress the MRSA and reduce the risk of infection during their stay in hospital and to reduce the spread of MRSA to other vulnerable patients. Elective orthopaedic and some other groups of surgical patients will be advised to contact their GP to obtain the MRSA treatment regime and to have 3 screens for clearance before admission.
Day surgery patients, or those with urgent admission dates seen in pre-admission clinic, will be advised to commence the 5 day decolonisation regime 4 or 5 days before their admission. The admission of a patient for treatment will not usually be delayed due to the result of an MRSA screen.
Advice regarding patients undergoing surgery that require prophylactic antibiotics can be obtained from the Microbiologist.
Patients will usually need to be isolated in a single room if admitted to hospital while still an MRSA carrier.
Assurance of compliance
Evidence that patients have been screened is monitored monthly. The results of the screening compliance are presented monthly to the IP&C Forum, Clinical Governance & Risk Committee and the Trust Board. Our aim is to be 100% compliant for Elective and Emergency admissions.
Screening Compliance
|
Elective |
Emergency |
April |
95% |
91% |
May |
97% |
92% |
June |
98% |
90% |