Methicillin-Resistant Staphylococcus Aureus (MRSA) presents unique challenges for nursing care. This comprehensive guide covers essential nursing diagnoses, interventions, and care plans to help nurses provide optimal care for patients with MRSA infections.
Understanding MRSA: An Overview for Nurses
MRSA is a strain of Staphylococcus aureus bacteria that has developed resistance to many common antibiotics, including methicillin and related drugs. As a healthcare provider, understanding proper nursing diagnoses and interventions is crucial for effective patient care and preventing the spread of this challenging infection.
Key Clinical Manifestations
MRSA infections can present in various ways, including:
- Skin and soft tissue infections
- Surgical site infections
- Pneumonia
- Bloodstream infections
- Bone and joint infections
- Urinary tract infections
Nursing Assessment for MRSA
Subjective Data Collection
- Patient history
- Recent hospitalizations or procedures
- Previous MRSA infections
- Current symptoms
- Risk factors
- Living conditions
- Recent antibiotic use
Objective Data Collection
- Vital signs
- Skin assessment
- Wound characteristics
- Laboratory results
- Imaging findings
- Culture and sensitivity results
Primary Nursing Diagnoses for MRSA
Let’s explore the most common nursing diagnoses for patients with MRSA infections, along with detailed care plans for each.
1. Risk for Infection Transmission
Nursing Diagnosis Statement:
Risk for Infection Transmission related to highly contagious organisms and lack of knowledge regarding transmission precautions.
Related Factors/Causes:
- Insufficient knowledge about infection control
- Poor hand hygiene practices
- Compromised skin integrity
- Presence of invasive devices
- Close living quarters
- Immunocompromised status
Nursing Interventions and Rationales:
Implement contact precautions
- Place the patient in a private room
- Use appropriate PPE
- Designate equipment for patient use only
Educate patient and family about transmission prevention
- Demonstrate proper hand hygiene
- Explain the importance of wound coverage
- Teach proper cleaning of personal items
Monitor healthcare worker compliance with infection control
- Ensure proper PPE usage
- Verify hand hygiene practices
- Maintain isolation protocols
Desired Outcomes:
- Zero transmission of MRSA to other patients
- Patient and family demonstrate proper infection control measures
- Compliance with isolation precautions
2. Acute Pain
Nursing Diagnosis Statement:
Acute Pain related to the inflammatory process and tissue invasion as evidenced by verbal reports of pain and guarding behavior.
Related Factors/Causes:
- Inflammatory response
- Tissue damage
- Wound formation
- Abscess development
- Surgical interventions
Nursing Interventions and Rationales:
Assess pain characteristics
- Use a standardized pain scale
- Document location and quality
- Monitor pain patterns
Implement pain management strategies
- Administer prescribed medications
- Position for comfort
- Apply cold/heat therapy as appropriate
Monitor the effectiveness of interventions
- Track pain levels
- Assess for side effects
- Adjust interventions as needed
Desired Outcomes:
- Pain level reported as manageable
- Improved functional ability
- Successful participation in activities of daily living
3. Impaired Skin Integrity
Nursing Diagnosis Statement:
Impaired Skin Integrity related to bacterial invasion and inflammatory response as evidenced by lesions and wound drainage.
Related Factors/Causes:
- Active infection
- Poor wound healing
- Compromised immune system
- Inadequate nutrition
- Mechanical factors
Nursing Interventions and Rationales:
Perform comprehensive skin assessment
- Document wound characteristics
- Monitor healing progress
- Identify new lesions
Implement wound care protocol
- Clean wounds per protocol
- Apply appropriate dressings
- Maintain sterile technique
Support healing process
- Optimize nutrition
- Promote hydration
- Manage comorbidities
Desired Outcomes:
- Progressive wound healing
- Absence of new lesions
- Improved skin integrity
4. Knowledge Deficit
Nursing Diagnosis Statement:
Knowledge Deficit related to unfamiliarity with MRSA infection management as evidenced by questions about self-care and prevention measures.
Related Factors/Causes:
- Limited exposure to information
- Misconceptions about MRSA
- Language barriers
- Complex medical terminology
- Anxiety about diagnosis
Nursing Interventions and Rationales:
Assess current knowledge level
- Identify gaps in understanding
- Address misconceptions
- Determine learning needs
Provide targeted education
- Explain infection process
- Teach prevention strategies
- Demonstrate self-care techniques
Evaluate comprehension
- Request return demonstration
- Answer questions
- Provide written materials
Desired Outcomes:
- Demonstrated understanding of MRSA
- Correct performance of self-care activities
- Verbalization of prevention strategies
5. Anxiety
Nursing Diagnosis Statement:
Anxiety related to diagnosis of MRSA infection and required isolation precautions as evidenced by expressed concerns and restlessness.
Related Factors/Causes:
- Isolation requirements
- Fear of complications
- Uncertainty about prognosis
- Impact on daily activities
- Social stigma
Nursing Interventions and Rationales:
Assess anxiety level
- Monitor behavioral cues
- Document verbal expressions
- Evaluate coping mechanisms
Implement support measures
- Provide emotional support
- Facilitate communication
- Encourage expression of concerns
Promote coping strategies
- Teach relaxation techniques
- Establish support system
- Set realistic goals
Desired Outcomes:
- Reduced anxiety levels
- Improved coping mechanisms
- Positive adjustment to diagnosis
Prevention and Education
Successful MRSA management requires comprehensive patient education focusing on:
- Hand hygiene
- Wound care
- Environmental cleaning
- Recognition of warning signs
- When to seek medical attention
- Medication compliance
References
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- Gurusamy KS, Koti R, Wilson P, Davidson BR. Antibiotic prophylaxis for the prevention of methicillin-resistant Staphylococcus aureus (MRSA) related complications in surgical patients. Cochrane Database Syst Rev. 2013 Aug 19;2013(8):CD010268. doi: 10.1002/14651858.CD010268.pub2. PMID: 23959704; PMCID: PMC11299148.
- Harding, M. M., Kwong, J., & Hagler, D. (2022). Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single Volume. Elsevier.
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- Hughes C, Tunney M, Bradley MC. Infection control strategies for preventing the transmission of meticillin-resistant Staphylococcus aureus (MRSA) in nursing homes for older people. Cochrane Database Syst Rev. 2013 Nov 19;2013(11):CD006354. doi: 10.1002/14651858.CD006354.pub4. PMID: 24254890; PMCID: PMC7000924.
- Ignatavicius, D. D., Rebar, C., & Heimgartner, N. M. (2023). Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care. Elsevier.
- Nandhini P, Kumar P, Mickymaray S, Alothaim AS, Somasundaram J, Rajan M. Recent Developments in Methicillin-Resistant Staphylococcus aureus (MRSA) Treatment: A Review. Antibiotics (Basel). 2022 Apr 29;11(5):606. doi: 10.3390/antibiotics11050606. PMID: 35625250; PMCID: PMC9137690.
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