MRSAstaph

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MRSA-staph

• A Common Sense Approach to Management
• November 1, 2007

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What is Staph?

• Staphylococcus Aureus are common bacteria found
  on skin or in the nose.
• 25-35 of healthy people carry staph
• In most cases these bacteria are normal and DO
  not present a health concern

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Staph in Schools

• We have seen staph infections in schools for
  years.
• Most commonly diagnosed as impetigo

Staph live on inanimate objects for months and
months!
Its everywheresupermarket, the mall,
restaurants, hospitals, nursing homes.
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What is ca-MRSA
Staph..MRSA.Whats the difference?

• Community Acquired Methicillin Resistant
  Staphylococcus Aureus
• A germ that commonly used antibiotics do not
  kill.
• Many believe its the over-use of antibiotics
  which have led to this superbug.

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Ca-MRSA (cont.)

• MRSA has been seen in hospitals and nursing homes
  for decades.
• Now seeing it in the community, hence the name
  (CA-MRSA)

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So if its that common, why is it in the news so
much?

• Student death triggers chain reaction.
• Public Health Authorities say there is NO
  epidemic nor unusual cluster of cases, as those
  two deaths were unrelated.
• Public Health Authorities view this as a chance
  to educate the public about prevention of this
  and many other diseases.

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What Does MRSA Look Like?

• Skin Infections that may appear as
• Pustule or Boil
• Little pus filled bumps
• May resemble a spider bite
• Become red, swollen, and painful
• Commonly occur at sites of visible skin trauma
  (cuts, abrasions, and areas of body covered by
  hair).

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MRSA Treatment

• Almost all MRSA infections can be treated by
  drainage of pus with or without antibiotics.
• More serious MRSA infections require
  hospitalization, possible wound debridement and
  IV antibiotics.

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MRSA Management In Schools

• The best way to prevent MRSA transmission is by
  frequent hand washing.
• If soap and water are unavailable, use 60
  alcohol based hand sanitizer.
• Skin infections must either be covered by a dry
  bandage which is sealed on all 4 sides or be
  non-draining prior to returning to school.

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Whos Job is it Anyway?

• This is NOT solely a Custodial Department issue!
• Everyone plays a part in prevention.
• Teachers need to make certain their students have
  frequent hand-washing opportunities.
• We all need to take ownership within our work
  environment.

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Custodial 101

• Cleaning- The general removal of soil from
  surfaces by standard methods. (Detergent, Water
  and Friction)
• Sanitizing- Reduce the number bacteria on
  inanimate objects to a safe level, but does not
  necessarily destroy organisms. e.g-sani-wipes,
  forks, knives, plates.
• Disinfecting- A process of destroying disease
  producing organisms. e.g- Quats, floors,
  counter-tops, bathrooms
• Sterilize- Destroy all forms of microbial life.
  This cannot be done in a school system!

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Cleaning

• Soil must be removed from surfaces first.
• School surfaces require regular cleaning and
  removal of soil and dust.
• The effectiveness of Disinfectants is reduced
  when soil exists.
• The physical action of scrubbing with detergents
  and rinsing with water removes large numbers of
  microorganisms from surfaces.

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General Strategies for Cleaning School Environment

• School surfaces can be divided into two groups
• Those with Minimal Hand Contact (e.g. floors,
  ceilings and windows)
• Those with High-Touch Hand Contact (e.g.
  doorknobs, hand rails, student desk tops, shared
  equipment, and restroom surfaces.

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High touch surfaces should be cleaned/disinfected
on a daily basis.
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Shared Equipment

• Cots, toys, diaper changing areas, should be
  cleaned/sanitized in between student use.
• Gym mats, athletic equipment such as lockers,
  benches, and weights, should be cleaned/sanitized
  after each use.
• Special education equipment such as feeders,
  chairs and personal care areas should be
  cleaned/sanitized after each use.

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Whose job is it?

• EVERYONEs.
• Common sense would say that shared equipment
  should be wiped down by instructional staff
  throughout the school day.
• Accidents containing blood or other bodily fluid
  would typically be the responsibility of the
  facilities department.

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Laundry

• Personal items such as towels and gym clothes
  should be taken home on a daily basis for
  laundering.

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On-Site Laundry

• Item such as towels, cover-ups, uniforms and mop
  heads, laundered at school need to have the
  following met
• Use detergent and wash in hot water cycle
• Dry in a dryer rather than line dry

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Products

• Check to see that your products are registered
  with the EPA as being effective against MRSA and
  other common bacteria and viruses.
• Maintain MSDS sheets.
• ALWAYS follow manufacturers instructions.

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The 10 Minute Rule
Important to note, most disinfectants need to be
on a hard surface for 5-10 minutes to be
effective.
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What about Carpeting????

• Studies have shown that microorganisms such as
  bacteria and fungi readily grow on carpet.
  However, there is limited evidence indicating
  that carpets influence health-care associated
  infection rates.
• Regular vacuuming can decrease microorganisms

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Carpet (cont.)

• Carpet extraction/cleaning should be performed on
  a regular basis as determined by internal policy.
• Spills such as blood and other bodily fluids
  require immediate spot cleaning using standard
  cleaning procedures and application of chemical
  disinfectants.

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Carpet (cont.)

• Most carpets can tolerate standard liquid
  chemical disinfectants.
• According to OSHA, carpeting contaminated with
  blood or other bodily fluids CANNOT be fully
  decontaminated.

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Personal Protective Equipment

• Gloves and eye protection should be worn when
  handling chemicals and other disinfectants.
• Hepa-type bags and filters should be used in all
  vacuums. They should changed regularly.
• Custodial equipment shall be maintained in good
  working order

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Buses

• Because the LISD transports special education
  students who are likely to be medically fragile,
  we have decided to implement nightly disinfecting
  of our buses. This is in addition to standard
  cleaning.

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MRSA in Schools

• MRSA awareness, at a minimum, should challenge
  each of us to examine current practices, identify
  areas of weakness and strengthen where needed,
  within reason.
• It is extremely important not to over-react in
  response to panic because we CANNOT render a
  sterile environment.

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References

• cdc.gov/features/mrsainschools
• CDC and the Healthcare Infection Contol Practices
  Advisory Committee, US Dept. Of Health and Human
  Services Atlanta, GA 2003
• Department Of Community Health MDCH Issues
  Guidance to Communities on MRSA October 26, 2007

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Questions????