Transcript MDRO Annual Physician Education with CRE

East Texas Medical Center – Tyler
Annual Physician Education
MDRO
-Multidrug-Resistant Organisms-
Revised: April 2013
Preventing
Multidrug-Resistant Organisms
(MDROs)
What the Direct Caregiver Should Know
Objectives:
Upon completion of this module, the learner will :
> Define Multidrug Resistant Organisms (MDRO)
> Name 2 MDROs
> State the type of precautions to be used with all patients and under what
circumstances you would wear gloves
> Name the type of isolation in which to place someone with an MDRO
What are Multi-Drug Resistant Organisms? (MDROs)
MDROs are microorganisms, predominantly bacteria, that are resistant to
one or more classes of antimicrobial agents
Examples of MDROs (not all inclusive) are:
Methicillin-resistant staphylococcus aureus (MRSA)
Vancomycin-intermediate staphylococcus aureus (VISA)
Vancomycin-resistant staphylococus aureus (VRSA)
Vancomycin-resistant enterococcus (VRE)
Streptococcus pneumoniae resistant to penicillin and other
broad-spectrum agents
Acinetobacter baumannii
Carbapenem-resistant Enterobacteriaceae (CRE)
What are Multi-Drug Resistant Organisms? (MDROs)
Other Examples of MDROs are:
Some gram-negative organisms with strains that have developed the
ability to produce ESBL (extended-spectrum beta-lactamase) which is an
enzyme that inactivates beta-lactam antibiotics such as the penicillins and
cephalasporins
Klebsiella pneumonia
Escherichia coli (E. Coli)
Acinetobacter baumannii
Stenotrophomonas maltophilia
Why Concern over MDRO Infections?
MDROs cause serious, difficult-to-treat infections that can
result in substantial morbidity, mortality, increased
lengths of stay and excess cost.
> Frequently preventable –
> Usually acquired via transmission by:
caregiver-to-patient, environment-to-patient, or patient-to-patient.
> Judicious use of antimicrobials may decrease incidence of
microorganisms developing antibiotic resistance.
What Measures Can We Take to Prevent Transmission of MDROs?
Hand Hygiene
(Hand hygiene. A general term that applies to hand washing using a antiseptic
handwash, antiseptic hand rub, or surgical hand antisepsis.)
The Most Important Way to Prevent Transmission of Microorganisms and Infection
What Other Measures Can We Take to Prevent Transmission of
MDROs?
> Isolation Precautions
> Follow Standard Precautions during all patient encounters
in all settings in which healthcare is delivered.
> Remember Standard Precautions is using appropriate personal protection
equipment (PPE) to protect against exposure to body fluids Gloves, gown,
mask and eye protection according to assessed risk of exposure
What Other Measures Can We Take to Prevent Transmission of
MDROs?
Isolation Precautions:
Develop and utilize systems to identify patients with MDROs and notify Infection
Preventionists, physicians and direct caregivers
Place patients with a confirmed MDRO or history of an MDRO in single-patient
rooms.
Group patients with the same MDRO in designated areas if single-patient room
unavailable.
What Other Measures Can We Take to Prevent Transmission of MDROs?
Isolation Precautions
Implement Contact Precautions immediately for all patients infected with MDROs,
that have a previously identified MDRO or have a history of being colonized with
target MDROs (Implementation of isolation is a nursing order . It does not require
a doctor’s order.)
Notify Infection Prevention and Control after placing the patient in isolation
What Other Measures Can We Take to Prevent Transmission of MDROs?
Contact Precautions
Perform hand hygiene before donning personal protective equipment (PPE – gown and
gloves)
Gown and gloves worn upon entering room
Use eye/face protection if risk of splatter/splash is anticipated (e.g., patient is coughing
or sneezing or has trach)
Discard PPE before leaving room
Perform hand hygiene after discarding PPE
What Other Measures Can We Take to Prevent Transmission of MDROs?
Isolation Precautions
For MDRO colonized or infected patients without draining wounds, or uncontrolled
secretions, establish ranges of permitted ambulation, socialization, and use of
common areas
Consult Infection Prevention & Control prior to discontinuing
isolation on a patient even if a physician has written an order for such
What Measures Can We Take to Prevent Transmission of MDROs?
Environmental Measures
Clean and disinfect high-touch surfaces (eg bedrails, faucet handles, door knobs) and
equipment used in the patient’s environment that may be contaminated with
pathogens
Dedicate noncritical medical items for use on patients known to be infected or
colonized with an MDRO Infected: organisms present, tissue invasion and symptoms are present
Colonized: organisms present, but no tissue invasion and patient is
asymptomatic
What Other Measures do Hospitals Take to Prevent
Development of MDROs?
Judicious use of Antimicrobial agents
Monitoring appropriate use of antimicrobial agents
Periodic development and distribution of antibiograms
Educating clinicians regarding appropriate prescribing of
antimicrobial agents
In Summary
Prevention of MDROs
Hand Hygiene, Hand Hygiene, Hand Hygiene
Isolation Precautions
Standard Precautions for all patients
Contact Precautions for patients identified as having an MDRO
Environmental Measures
Judicious use of Antimicrobial agents
Antibiogram can be found in the Links of OneChart
Antibiogram can be found in Links of OneChart
Reference:
http://www.cdc.gov/ncidod/dhqp/pdf/ar/mdroGuideline2006.pdf
I ___________________certify I have completed
the Annual Education presentation on
MDRO (Multi Drug Resistant Organisms)
Print Name ____________________
Sign ______________________
Date ___________