MRSA Nursing Diagnosis & Care Plan

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:

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

  1. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2023). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. 
  2. 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.
  3. Harding, M. M., Kwong, J., & Hagler, D. (2022). Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single Volume. Elsevier.
  4. Herdman, T. H., Kamitsuru, S., & Lopes, C. (2024). NANDA International Nursing Diagnoses – Definitions and Classification, 2024-2026.
  5. 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.
  6. Ignatavicius, D. D., Rebar, C., & Heimgartner, N. M. (2023). Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care. Elsevier.
  7. 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.
  8. Silvestri, L. A. (2023). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. 
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Anna Curran. RN, BSN, PHN

Anna Curran. RN, BSN, PHN I am a Critical Care ER nurse. I have been in this field for over 30 years. I also began teaching BSN and LVN students and found that by writing additional study guides helped their knowledge base, especially when it was time to take the NCLEX examinations.

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