The registered nurse is caring for a 48-year-old patient with a surgical wound infected with methicillin-resistant Staphylococcus aureus (MRSA) requiring q6h intravenous antibiotic infusions and dressing changes twice per shift. The patient with which diagnosis is most appropriate to be added to this nurse’s assignment?

Question

The registered nurse is caring for a 48-year-old patient with a surgical wound infected with methicillin-resistant Staphylococcus aureus (MRSA) requiring q6h intravenous antibiotic infusions and dressing changes twice per shift. The patient with which diagnosis is most appropriate to be added to this nurse&rsquo;s assignment?

Accepted Answer

Sepsis due to MRSA bacteremia requiring mechanical ventilation, q6h antibiotics, and q2h breathing treatments. In order to decrease the spread of drug resistant organisms such as methicillin-resistant Staphylococcus aureus, patients with MRSA should be cohorted together. More importantly, they should not (when possible) be cohorted with patients with other resistant organisms to prevent the patient having more than one resistant organism. Therefore, the most appropriate patient is the patient with MRSA bacteremia. Norovirus diarrhea is not a diagnosis that necessarily needs to be cohorted, but should not be cohorted with the MRSA patient. The patient with ARDS may or may not have a drug-resistant organism but is not the most appropriate pair. The patient with the purulent wound that smells of grape juice likely has a Pseudomonas aeruginosa infection; this patient should not be cohorted with the patient with MRSA to prevent coinfection in either patient.

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