VRSA
- VISA SUMMARY
Updated 11/03 |
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Introduction
Vancomycin-Resistant Staphylococcus Aureus has the potential
to become a prevalent, virulent and transmissible bacterium for which
no effective therapy would be available. Due to the severity of this organism,
at The John's Hopkins Hospital the VRSA/VISA policy is effective immediately
upon identification of a patient with the organism.
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Early Identification
Microbiology
The microbiology lab shall immediately notify Hospital Epidemiology and Infection
Control (HEIC), the attending physician or covering attending physician, the nursing
unit and the Infectious Disease Consult Service when VISA/VRSA is isolated from a
patient specimen.
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Start Isolation
Special Precautions
All patients colonized or infected with VISA/VRSA shall be placed in a private room
on Special Precautions. In addition, a standard surgical mask must be worn by all
employees, students, volunteers and visitors when caring for such patients with
respiratory symptoms and those receiving aerosol treatments (i.e., nebulizations and
oxygen).
Infectious Disease Consult
Patients must have an Infectious Disease (ID) Consult. ID will review
the patient's antimicrobial therapy.
Limit the Number of Healthcare Workers
The number of healthcare workers (HCWs) who come in contact with the VISA/VRSA patient
shall be limited. Healthcare workers known to be at high risk for staphylococcal
colonization (those with exfoliative dermatitis) shall not care for patients with
VISA/VRSA. Names of all employees, students and volunteers who come in contact with
VRSA patients must be monitored by the unit. Until more is learned about the
epidemiology of VRSA, all HCWS caring for the patient shall have surveillance
cultures for VRSA as organized by HEIC based on the individual circumstances
surrounding the patient and his/her care.
A log of individuals entering the patient’s room
will be maintained on nursing unit.
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Contain the Spread by Taking Additional
Precautions:
- Hand Hygiene Cleanse with an approved antimicrobial
soap or alcohol based waterless hand sanitizer when gloves are removed, before and after patient
care, and/or after contact with environmental surfaces.
- Dedicate Equipment/Supplies.,
Use disposable supplies that must be discarded when the patient is
discharged. Disposable supplies should be transferred with the patient to other units or
procedure areas.
- Limit Patient Transport
When possible, preform procedures at the bedside. When
transporting paients, Special Precautions must be followed.
Evironmental surfaces, such as doorknobs and elevator buttons, can become contaminated
during transport. Dedicate one memeber of the transport team to be in contact with
environmental surfaces only.
- Specimen Transport in a double,
leakproof bag, hand delivered directly and immediately to the lab. DO NOT SEND
SPECIMENS THROUGH THE PNEUMATIC TUBE SYSTEM
- Thorough Terminal Room Cleaning after the patient
is discharged is necessary. The room must remain closed to new admissions until
approval by HEIC.
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