Medical Malpractice Related to Nosocomial MRSA Infections, comment


Prescreening patients for MRSA prior to admission to the hospital is a very proactive approach to managing this “super bug”.  If we consider this part of our pre-surgical admission assessment rather than a legal issue, we can take some of the unnecessary fear and anxiety that has been instilled in the public from the media regarding MRSA. When patients are screened for Group B Strep prior to a vaginal delivery, it provides health care providers with useful information to treat the patient and potentially the infant prophylactically and could potentially save the hospital, patient and insurance companies money from complications.  We should consider MRSA in a similar scope because it is no longer rare and only nosocomial in nature, but it is commonly acquired in the community as well.  Prescreening patients upon admission, whether it be inpatient or outpatient, can only improve outcomes for patients and healthcare providers.  This does not have to be seen as a legal issue, or a means to panic the community needlessly, but rather a way of arming ourselves with information to provide the best quality care possible.  Protocols need to be established to prevent and control MRSA before it enters our patient environment, while still treating those who are carriers in a non-discriminatory manner.

Original Post

June 7, 2010

Title: MRSA frustrations! (comment)

I feel the same frustrations as posted in the attached! I feel like we, the nurses, are viewed as the Culprit in a patient acquiring a nosocomial infection. Never mind the fact that ‘we’ probably wouldn’t be in this predicament if these wonder drugs, antibiotics, hadn’t been given for every sore throat and cold that walked into the Dr’s office, clinic, or ER. In the hospital where I work, there is an ongoing ‘tally’ of hospital-acquired UTI, VAP, central-line infections, etc., by unit. It’s hard enough to work short-staffed, but to also glove and wash your hands every time you enter a patients presence then leave, just to enter another and wash all over again; takes even more time away from patient care and interactions; all the while someone standing over your shoulder monitoring… The pharmaceuticals have some ownership of this ‘super-bug’ epidemic. I don’t think they invested enough time and research into developing new antibiotics, because it didn’t make the money the other drug classes did.

Original Post

May 26, 2010

Title: Medical malpractice related to nosocomial MRSA infection, comment

After reading the posts regarding MRSA acquired during the hospitial stay and how this is a legal issue makes me think of one thing. Nurses need a law degree before stepping foot in a hospital. Well, that may be a little overboard. I see this everyday. Practicing medicine while keeping in mind that we can be sued. We order extra lab work, radiology, ultrasound, MRI, and swabs for MRSA so we cover all the bases and avoid going to court. I can understand the MRSA swabs that may need to be done in order to avoid a lawsuit, but we would have to swab everyone. We really don’t know if the history we are obtaining is inclusive. Is this done in other countries? Are people “sue happy”? This is a foriegn concept to some friends and family that visit the US. Maybe we can invent a body scan that will take photographs head to toe to cover wounds, swab every orifice, lower the beds to 1 foot off the ground, and make it mandatory to wear special non-slip shoes to avoid falls. Again, the above example is out of frustration that we are not only caring for patients, but always are adding new things to do in order to avoid a lawsuit. I wish it were different, but we all know it will only get worse.

Original Post

January 16, 2007

Title: Medical Malpractice Related to Nosocomial MRSA Infections

The media and government have educated the public in the “super bugs” some patients become infected with in the hospital environment. The most widely known “super bug” is methicillin resistant staphylococcus aureus (MRSA). In June 2006 there was a case brought to court regarding the death of patient who had been in the hospital for a knee joint replacement. Since the patient had not been screened for MRSA prior to hospitalization it could not be proved if he picked up the MRSA during the hospital stay. With the documented community acquired MRSA he could have had the bacteria dormant in his body when he was admitted for the planned surgery. The doctor and hospital were not found negligent in this case.

Many hospitals are fearful of similar lawsuits based on nosocomial infections. Some hospitals are now culturing high-risk patients prior to hospital admission to determine if they are colonized. There is now a nasal swab test that has a turn around time of two hours to identify MRSA. Certainly this can be helpful so that colonized patients coming in for elective procedures can have this treated and also be isolated from non-colonized patients. Patients that test positive for MRSA can be cohorted with like patients or put in private rooms. There are multiple hospitals in Europe starting to follow this intervention with positive outcomes in their nosocomial rates.

It would seem to me the hospital administrators would prefer paying for the MRSA culture versus facing the potential of law suits from patients who develop nosocomial MRSA infections while inpatient. If I had a family member going to the hospital I would much prefer they be tested for MRSA prior to a surgery as “knowledge is power” Having the knowledge of colonized MRSA prior to surgical intervention can allow for adjustments that lead to positive outcomes for the hospital, surgeon and patient. I can visualize hospitals even being forced to do it to allow them better leverage in the court system by being able to say, “this person was colonized with MRSA” prior to hospital admission. From the epidemiology stand point it would also allow the opportunity to keep the more virulent strain of community MRSA from entering the hospital environment.

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