The National Burn Centre, Middlemore Hospital,, Private Bag 93311, Auckland 1640, Jackie.Beaumont@middlemore.co.nz
Anecdotally it appears that a proportion of burn patients admitted to our unit are discharged with a hospital acquired infection. Burn patients are a high risk group and infection is a leading cause of morbidity and mortality.
All patients admitted to our hospital are screened for multi-resistant organisms (MROs) as per the organisation’s screening criteria. This does not include routine screening for long term patients for MROs, making it impossible to determine the origin of these infections. Following a discussion with the Infection Control and Microbiology team data was obtained for all in-patients identified with an MRO, including types of MRO isolated, over a two year period.
As a result questions were raised: Is there cross transmission of infection, and if so how is this cross transmission occurring? Also, what impact does that have for the patient and the organisation?
It was determined that a pilot study should commence for a period of three months to identify the number of patients colonised with an MRO. This would include, in addition to routine screening of all admissions to the National Burn Centre, an introduction of weekly MRO screening for MRSA (methicillin-resistant staphylococcus aureus) and ESBL (Extended Spectrum Beta Lactamase) for long term patients (LOS> 7 days). At the end of the pilot study it would be decided, depending on the results, whether to continue with routine MRO screening for long term patients. Other issues identified by the study would be investigated and addressed as appropriate to the particular circumstances discovered or raised.
I am a registered nurse with 21 years experience. Most of this time has been spent within the area of burn care. I have held the position of Burn Clinical Nurse Specialist for the last five years at the National Burn Centre, Middlemore Hospital, in Auckland.