Wednesday, October 17, 2007

MRSA, When Should Disclosure Be Required?!

Should hospital staff that test positive as carriers for MRSA be allowed to continue to work with seriously ill patients? I say NO! Why? Given all the guidelines for prevention, there are still outbreaks in the hospitals.






A hospital staff member that is a carrier of MRSA just needs to sneeze into their hand and turn a door knob to get the spreading started. Prevention, it is easy, but, it will take a few minutes of your time.





http://www.cdc.gov/od/oc/media/pressrel/fs021025.htm, click at this site for correct hand washing guidelines.

The BC Health Files states "...you do not need treatment and you should continue with your normal activities" and "You do not need to disclose to your workplace, school or daycare setting the fact that you carry MRSA. " What! If I had children, I would not place them in a daycare where any individual is a carrier of MRSA.

The BC Health Files states for hospital visits, "Important: If you may be a carrier of MRSA and are going to be admitted into hospital, it is very important for you to let hospital admitting staff know. Steps will be taken to protect other patients and hospital staff from MRSA infection." This should be the case in all institutions. At the hospital you need to protect those that are seriously ill-Yes.


What about in the community with the weak elderly, young children, or immunocompramised individuals. Do they not have the right to be protected like the Hospital Staff?


It IS important to let your employer, school, daycare...etc know if you are a carrier of MRSA.



Image. http://www.cartoonstock.com/newscartoons/cartoonists/mfl/lowres/mfln242l.jpg
BC HealthFile #73, September 2005. http://www.bchealthguide.org/healthfiles/hfile73.stm#hf0735

3 comments:

Azigay said...

"Should hospital staff that test positive as carriers for MRSA be allowed to continue to work with seriously ill patients? I say NO!"

I disagree. You have hardly addressed this issue. I do, however believe that your MRSA status should be known to daycares, hospitals, and the like.

But with what right do we have to let good staff go. They are not voluntarily infected. It is a workplace hazard. Doctors and nurses worked hard to get to where they are; if we fire them because they test positive where will they go and who do we have to replace them. Then next round of hospital staff will eventually become infected as well.

Then again, how do you define seriously ill. I would think anyone who is in a hospital must be seriously ill. It would be hard to draw a line across which patients doctors can or cannot treat. What if a patient who was not considered seriously ill becomes so? What happens to the doctor who was treating that patient. It would swamp the other doctors to hand off patients because of their illness level.

Obviously, better preventative measures must be taken, but removal of skilled physicians is not the required step. Mandatory screening of all in the hospital, isolation and proceedures relating to and including hygeine, dress code...etc appear to be necessesary if we mean to lower the infection rate but firing staff is the wrong route to take.

Dominic said...

Not so sure....! I think the proportions of healthcare workers being positive for MRSA is probably quite high (I have no proof of that and no studies to refer to) simply because they work in an environment where MRSA and other bacteria are prevalent. If we prevent people to work because they are positive for MRSA then I fear that we will have to replace them very frequently. This way valuable expertise would be loss. I think it is a question of risk management. I understand your concern and agree to a point but disclosure would instigate fear in a population that does not know too much about microbes.

Dar said...

I believe I did not say to "let the staff go". It was for them to not work with seriously ill patients. A good many people are not seriously ill if they are requiring a stay at a hospital. There are a number of wards people are not immunocompromised and at high risk for infection.

All those preventative measures are already recommended. Again, I said nothing about firing staff at a hospital. It was relocating them to treat the not seriously ill.