MRSA Information for patients Infection Prevention and Control Large Print
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What is MRSA? MRSA is a bacterium (germ), which can be found living on the skin of healthy individuals, particularly in the lining of the nose and other warm moist areas of the body. The bacterium can live on the skin without detection and without causing any harm. This is called colonisation. However, if the bacterium enters the body or bloodstream through a wound, for example, it can cause an infection. MRSA is short for Meticillin-Resistant Staphylococcus Aureus. It's part of the staphylococcus aureus 'group' but is resistant to some antibiotics we commonly use to treat infection. However, MRSA infection is treatable with certain other antibiotics. page 3 of 16
How do I know if I have got MRSA? You may have had swabs taken by: Your GP, practice nurse or other community healthcare worker. The hospital, on admission or when attending a pre-assessment clinic. Routine swabs of your nose and usually your groin will be taken. If you have any wounds (e.g. leg ulcers/surgical wounds) swabs will also be taken from these areas. The results of your swabs will usually be available after 48 hours. The medical/nursing staff looking after you in the community or in the hospital will inform you of the results of the swabs. We will also contact your GP to inform them of your MRSA results, so they are aware of the situation and the need for an assessment. If you have attended hospital and swabs were taken, but you were discharged home before the results of your swabs were available, we ll send you this leaflet along with a letter advising you to contact your GP and arrange an assessment. page 4 of 16
Why is it important to know if I have got MRSA? If MRSA is found in your body swab or nose swab, your colonisation can be reduced by the use of antiseptic washes and nasal ointment. This will reduce the likelihood of the bacteria infecting a wound or gaining entry into the blood stream. How did I get MRSA? The MRSA may already have been on your skin or in your nose before your GP took swabs or before you came into hospital, or you may have it on your skin/in your nose since your admission. It is usually spread by contact and can be transferred by hands. What are the signs and symptoms? MRSA can live on the skin and in the nose without detection and without causing any signs or symptoms. It can sometimes cause infections including boils, abscesses and wound infections. page 5 of 16
What happens if I have MRSA in hospital? If you are shown to have MRSA whilst in hospital the following steps will be taken: You will be requested to move to a side room (if available). Medical and nursing staff will wear gloves and an apron when in contact with you. Medical and nursing staff will continue thorough hand washing before and after contact with you. Your room will be cleaned on a daily basis. You will be provided with your own toilet/commode, which will be cleaned by staff on a regular basis. You will be started on antiseptic body washes and ointment for your nose, known as nasal ointment. If you have been in hospital but have been discharged before the results of your swabs were available, we ll send you this leaflet along with a letter advising you to contact your GP and arrange an assessment. We will also contact your GP to inform them of your MRSA results, so they are aware of the situation and the need for an assessment. page 6 of 16
What happens if I have MRSA at home? The best treatment option for you, if you require any at all, will depend on your particular circumstances. Treatment may be considered if you have an underlying medical problem or require surgery in the near future. If you require treatment you will be started on antiseptic body washes and ointment for your nose, known as nasal ointment, prescribed by your GP. If you require treatment it s best to change your towel, underwear, clothing and nightwear daily whilst on treatment. Whilst at home you should not restrict your usual activities; work, family and social life should continue as normal. Healthcare workers visiting you at home will wear gloves and aprons whilst caring for you. Healthcare workers will perform hand hygiene before and after contact with you. Further nasal/body swabs will be taken to see if the treatment has been effective. In some cases repeat courses of treatment may be necessary. If you require repeat courses of treatment these will be prescribed by your GP. page 7 of 16
How do I use the antiseptic washes? The antiseptic washes are used for five days. The nursing staff will explain how to use the antiseptic washes correctly and will help you if you need assistance in hospital. Whether at home or in hospital it s best to change your towel, underwear, clothing and nightwear daily whilst on treatment. In hospital you will be provided with clean bed linen and a clean towel every day. In hospital you will also be provided with disposable wipes to wash with every day instead of a flannel. Disposable wipes or a clean flannel daily are recommended for use at home. Your hair should be washed twice during the five days of treatment, using the antiseptic wash. How do I use the nasal ointment? The nasal ointment is also used for five days. A small amount of ointment is inserted into each nostril 2-3 times a day, depending on your prescription. page 8 of 16
How effective is the treatment? Many people only need one course of treatment. For some other people further courses of treatment may be needed. Are there any side effects or risks? Occasionally, you may experience skin irritation or a rash. If this occurs, please inform the nursing staff looking after you at home or in hospital immediately or inform your GP. Other antiseptic washes are available to use should irritation occur. Do I need to stay in hospital until I have completed my treatment? No. If you are medically fit, you can complete the antiseptic washes and nasal ointment at home. Continue to put on clean underwear and clothes each day whilst using the antiseptic washes and nasal ointment. After you ve completed the antiseptic washes and nasal ointment, you should put clean linen on your bed. You may wish to vacuum your mattress. Return any remaining antiseptic wash/nasal ointment to the local pharmacy. page 9 of 16
How will I know if the treatment is working? Body and nasal swabs will be taken again two full days after you ve completed the five day course of antiseptic washes/nasal ointment. If you are discharged home from hospital on your treatment, you can arrange for your district nurse or practice nurse to take some more swabs. If you started or completed treatment for MRSA whilst in hospital your GP will be informed of this by letter. What will happen next? If you re still in hospital you will need 3 sets of body/nasal swabs that are negative for MRSA before you will be moved out of the side room. You will have regular body/nasal swabs taken whilst you stay in hospital. If you have any healthcare professionals visiting you at home, please inform them that you have had MRSA so they can help make any arrangements necessary for your care. page 10 of 16
Is there anything I should stop or avoid doing in hospital or at home? Some helpful precautions if you have MRSA include: It is important to stay in your side room as much as possible whilst you re in hospital and avoid contact with other patients while you are on antiseptic treatment. Whilst at home you should not restrict your usual activities; work, family and social life should continue as normal, including while you are on antiseptic treatment. Avoid touching any intravenous lines, cannulae, catheters or wounds you may have. Avoid using cotton handkerchiefs and use disposable tissues instead. Do not use a roll-on deodorant. Use a spray-on deodorant. page 11 of 16
Is there anything else I can do to help myself during my hospital admission? Ensure you wash your hands well at all times, particularly before eating and after using the toilet. During your five days of antiseptic washes, please put on clean underwear and clothes/nightwear every day (nightwear can be provided by the hospital if needed). Encourage your visitors to use the alcohol hand gel provided on entering and leaving the ward. Please feel free to ask staff if they have washed their hands; they really do not mind and are expecting you to ask them. page 12 of 16
Can I still have visitors during my hospital admission? You can have visitors. MRSA will not harm healthy people who visit you in hospital. We do however recommend the following: It is not recommended for children under the age of 12 years to visit the hospital. Visitors are requested to use the alcohol hand rub provided on entering and leaving the ward. Visitors are advised to cover any wounds with a dressing. Gloves and aprons do not need to be worn by your visitors unless they are directly involved in carrying out your care. If visitors are taking laundry home, it should be washed separately on a hot, detergent wash. Nursing staff will provide bags to take laundry home. If your clothing is badly soiled we prefer not to ask your visitors to wash it at home; with your permission we would prefer your clothing to be clearly labelled and sent to our laundry. page 13 of 16
How will it affect my family and friends at home? Live a normal life and continue your communal living. Whilst at home you should not restrict your usual activities; work, family and social life should continue as normal. Continue with your normal sleeping arrangements with your partner. Change and launder your bedding frequently. Continue good hand washing and daily personal hygiene, regularly changing underwear and clothing. Liquid soaps are preferable to bars of soap. Use separate flannels and towels. Change and launder them frequently. Ensure any cuts or wounds are suitably covered. Household laundry, crockery and cutlery do not need to be treated differently or washed separately. Maintain good basic housekeeping by vacuuming and dusting. If you have any concerns, please contact your GP for further advice. page 14 of 16
What happens if I come into hospital in the future? It would be helpful if you inform nursing staff that you have had MRSA in the past. You will have more body/nasal swabs taken and a side room will be provided for you (where available). Who can I contact if I have any questions? The doctors and nurses looking after you will be able to answer any questions you have. The Infection Prevention and Control Team are also available to answer any queries you may have. The Infection Prevention and Control Team can be contacted directly on: Northern General Hospital 0114 271 4569 Royal Hallamshire Hospital, Weston Park, Jessop Wing 0114 271 3120 Where can I find more information? Further information about MRSA is available via the Public Health England website https://www.gov.uk/government/organisations /public-health-england page 15 of 16
Produced with support from Sheffield Hospitals Charity Working together we can help local patients feel even better To donate visit www.sheffieldhospitalscharity.org.uk Registered Charity No 1169762 Alternative formats can be available on request. Please email: alternativeformats@sth.nhs.uk Sheffield Teaching Hospitals NHS Foundation Trust 2018 Re-use of all or any part of this document is governed by copyright and the Re-use of Public Sector Information Regulations 2005 SI 2005 No.1515. Information on re-use can be obtained from the Information Governance Department, Sheffield Teaching Hospitals. Email infogov@sth.nhs.uk PD7543-PIL1564LP v5 Issue Date: November 2016. Review Date: November 2019