Date of Award

8-2000

Document Type

Independent Study

Degree Name

Master of Science (MS)

Abstract

Methicillin resistant Staphylococcus aureus (MRSA) is a pathogen first emerging in Great Britian in 1961. Since that time, it has spread worldwide and caused epidemic infection rates in several countries. It is most commonly spread in the healthcare setting where it is labeled a "nosocomial" infection, frequently infecting patients undergoing invasive medical procedures and immune-compromised patients. Depending on the severity and location of infection in conjunction with the patient's health status, MRSA infection can be mild to fatal. The surgical setting is a key area of concern. Cardiac surgery complicated by MRSA is relatively rare, but when it does occur, the associated mortality rate is alarmingly high. It is also possible to contract MRSA in the public setting where it is labeled "community-acquired" MRSA (CA-MRSA). CA-MRSA infections can range from simple skin infections to devastating infections such as bacteremia leading to death. The incidence of CA-MRSA has risen to approximately 14% of all MRSA infections. The purpose of this project was to explore the incidence of MRSA and its ramifications focusing on the cardiac surgery patient. Pasteur's germ theory provided a theoretical framework to uncover the causative organism and how it spreads to susceptible hosts. Appropriate measures for prevention and treatment were explored. This paper informs nurse anesthetists how to prevent the spread of MRSA in the cardiac surgery patient. Preventing MRSA in the cardiac surgery patient include strict contact isolation precautions in the surgical setting in the presence of MRSA, appropriate and timely preoperative prophylactic antibiotic administration, and vigilant intraoperative glycemic and the1moregulatory control of patients. This project was presented to two audiences: The first was a 10-minute PowerPoint presentation given at the spring meeting of the North Dakota Association of Nurse Anesthetists. The second was a 50-minute inservice presented to CRNAs and nursing staff at a Midwestern facility. Providing awareness of the growing problem of MRSA infections is the first step in reversing the trend of increasing infections. Active participation by healthcare providers in applying prevention methods provided in this project will help to prevent the spread of MRSA in the patients for whom they provide care

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