Login

CHW211-MRSA Prevention and Management Policy

{{org_field_logo}}

{{org_field_name}}

Registration Number: {{org_field_registration_no}}

MRSA Prevention and Management Policy

1. Purpose

The purpose of this policy is to establish clear guidelines for the prevention, management, and control of Methicillin-Resistant Staphylococcus Aureus (MRSA) within {{org_field_name}}. This policy aligns with Care Inspectorate Wales (CIW) regulations and national infection prevention and control standards to protect residents, staff, and visitors from the risks associated with MRSA. It provides a structured approach to identifying, treating, and minimising the spread of MRSA within the care home environment.

2. Scope

This policy applies to all residents, staff, agency workers, contractors, and visitors within {{org_field_name}}. It covers screening, hygiene practices, isolation procedures, staff responsibilities, and treatment protocols for MRSA. It ensures a proactive approach to infection control to maintain the highest standards of hygiene and resident safety.

3. MRSA Prevention and Control Measures

3.1 Understanding MRSA and Transmission Risks

MRSA is a type of bacteria resistant to common antibiotics, making infections difficult to treat. It is primarily spread through direct contact with an infected person, contaminated surfaces, or via the hands of healthcare workers. The highest risk of transmission occurs in communal living environments, such as care homes, where residents may have open wounds, invasive devices, or weakened immune systems. Staff must be vigilant in recognising the risks and implementing strict hygiene controls to prevent outbreaks.

3.2 Identification, Risk Assessment and Screening for MRSA

MRSA colonisation means that MRSA is present on or in the body without causing signs or symptoms of infection. MRSA infection means that the organism is causing clinical illness. Staff must distinguish between colonisation and active infection when deciding what infection prevention and control measures are required.

On admission, readmission or transfer into {{org_field_name}}, the service must obtain relevant information about known or suspected infection risks, including any current or previous MRSA or other multidrug-resistant organism status, where this information is available and relevant to the resident’s care. An individual infection transmission risk assessment must be undertaken and kept under review.

A resident must not be refused admission, readmission or access to ordinary care-home life solely because they are known to be colonised with MRSA. Any additional precautions must be based on an individual assessment of the risk of transmission, taking account of factors including active infection, open or draining wounds, invasive devices, continence, the resident’s ability to maintain personal hygiene and the vulnerability of other residents.

Routine MRSA screening must not be undertaken solely because a resident is being admitted or transferred to the care home. MRSA screening will only be undertaken where this has been clinically indicated or requested by an appropriate healthcare professional, Infection Prevention and Control Team or Health Protection Team. Where screening is required, specimens must be taken in accordance with the instructions of the healthcare professional or laboratory responsible for the investigation.

Where a resident is known or found to have MRSA, this must be recorded in the resident’s relevant care documentation and infection risk assessment. Appropriate infection prevention and control measures must be incorporated into the resident’s personal plan where necessary. Staff must seek advice from the relevant healthcare professional, Infection Prevention and Control Team or Health Protection Team where the appropriate precautions are unclear.

Where the resident is transferred to another health or care provider, relevant MRSA or other multidrug-resistant organism status must be communicated to the receiving provider in accordance with information-governance requirements so that safe continuity of care can be maintained.

3.3 Infection Prevention and Control Measures

Standard Infection Control Precautions must be applied by staff when caring for all residents, regardless of whether MRSA or another infection is known to be present. Where Standard Infection Control Precautions alone are insufficient because a resident has an active MRSA infection or presents an increased transmission risk, appropriate Transmission Based Precautions must also be implemented following an individual risk assessment and, where necessary, advice from the Infection Prevention and Control Team or Health Protection Team.

Hand hygiene is a principal measure for preventing the transmission of MRSA. Staff must perform hand hygiene at the appropriate points before and after resident contact, following contact with the resident’s immediate environment where indicated, after removing gloves or other PPE, and following any activity which may result in contamination of the hands. Liquid soap and warm running water must be used where handwashing is required. Alcohol-based handrub may be used when appropriate where hands are visibly clean and there is no infection-specific requirement for washing with soap and water.

Personal protective equipment must be selected according to the activity being undertaken and the assessed risk of exposure or transmission. Disposable gloves must be worn where exposure to blood, body fluids, mucous membranes, non-intact skin or contaminated items is anticipated. A disposable apron must be worn where there is a risk that clothing may become contaminated and when required as part of contact Transmission Based Precautions. Additional PPE, including facial or eye protection, must be used where the task creates an identified risk of splashing or exposure requiring such protection. PPE must be removed safely and disposed of in accordance with the Infection Prevention and Control Policy, followed immediately by appropriate hand hygiene.

Where MRSA is present in a wound, the wound must be covered with an appropriate dressing wherever clinically suitable and wound care must be undertaken using the appropriate aseptic technique by staff who are trained and competent to perform the procedure.

Reusable care equipment must be cleaned and, where indicated, disinfected between residents and after use in accordance with the manufacturer’s instructions, the Infection Prevention and Control Policy and current national infection prevention and control guidance. Wherever practicable during active infection or transmission-based precautions, equipment should be dedicated to the individual resident where this reduces the risk of transmission.

Frequently touched surfaces and the resident’s environment must be cleaned at the frequency and to the standard required by the service’s cleaning schedules and the resident’s assessed infection risk. Enhanced cleaning and disinfection must be implemented where required for active infection, transmission-based precautions or outbreak management.

Used linen and clothing must be handled as little as possible, must not be placed on the floor or other environmental surfaces, and must be placed directly into the appropriate laundry bag or system. Linen must be processed in accordance with the service’s infection prevention and control and laundry procedures and current national guidance. MRSA colonisation alone does not require a separate blanket laundering process unless advised following an infection risk assessment.

Waste arising from care must be segregated, handled and disposed of using the appropriate waste stream in accordance with the Infection Prevention and Control Policy and applicable waste-management requirements.

3.4 Placement, Isolation and Movement of Residents with MRSA

MRSA colonisation alone is not a reason to isolate a resident. A resident who is colonised with MRSA and who does not otherwise present an active transmission risk must be supported to continue their normal daily life, including access to communal rooms, dining facilities, activities, visitors and other appropriate areas of the care home.

Any decision to implement isolation or additional Transmission Based Precautions must be based on an individual infection transmission risk assessment. Factors to be considered include whether the resident has an active MRSA infection, an infected or heavily draining wound, uncontrolled body-fluid contamination or another clinical factor that creates an increased risk of transmission.

Where single-room isolation is clinically or infection-control indicated, the reason for isolation, precautions required, review arrangements and anticipated duration must be documented. Isolation must continue for no longer than necessary. The resident’s dignity, rights, emotional well-being, communication needs and social contact must be considered and supported throughout the period of isolation.

Where an infected wound is present, it must be appropriately covered wherever clinically possible. The resident must continue to receive person-centred care, treatment, activities and social contact subject only to infection-control restrictions that are necessary and proportionate to the identified risk.

The service must seek advice from the local Infection Prevention and Control Team or Health Protection Team where there is uncertainty about isolation, where transmission is suspected, or where more than one linked case occurs.

Cohorting of residents or staff must not be introduced automatically because multiple residents are MRSA-positive. Any cohorting arrangements must be based on an outbreak or transmission risk assessment and implemented in consultation with the relevant Infection Prevention and Control Team or Health Protection Team.

3.5 Treatment and Medical Management

MRSA infections may require topical treatments, antibiotic therapy, or wound care, depending on the severity of the infection. Topical decolonisation treatments, such as antibacterial nasal ointments and antiseptic body washes, may be prescribed for colonised residents. Systemic antibiotic treatment will be determined by the resident’s GP or infectious disease specialist, and all medication must be administered according to the Medication Management and Administration Policy (CHW21). Staff must monitor residents for signs of infection, including fever, swelling, or worsening wounds, and report any concerns immediately.

3.6 Staff Training and Compliance

All staff must receive annual training on MRSA prevention, infection control, and safe handling of contaminated materials. Training will cover correct handwashing techniques, PPE usage, proper cleaning protocols, and emergency response measures for MRSA outbreaks. Compliance with infection control policies will be monitored through routine audits, spot checks, and staff performance evaluations. Any staff member failing to adhere to infection control procedures may be subject to disciplinary action under the Staff Conduct and Code of Ethics Policy (CHW28).

3.7 Environmental Cleaning and Decontamination

{{org_field_name}} must maintain documented cleaning programmes and schedules which are appropriate to the premises, resident population and infection risks. Cleaning arrangements must include responsibility for each area, the frequency of cleaning, the products and equipment to be used and arrangements for monitoring standards of cleanliness.

The environment of a resident who is colonised with MRSA must be cleaned routinely to the required care-home standard, with particular attention to frequently touched surfaces. MRSA colonisation alone does not require indiscriminate use of disinfectant throughout the home.

Where a resident has an active MRSA infection, is being managed using Transmission Based Precautions or has otherwise been assessed as presenting an increased transmission risk, enhanced environmental cleaning and, where indicated, disinfection must be undertaken using products and concentrations appropriate to the organism and surface concerned and in accordance with manufacturer’s instructions and current infection prevention and control guidance.

Frequently touched surfaces, including door handles, call bells, light switches, handrails, sanitary fittings and items of care equipment, must be included within the appropriate cleaning schedule.

Reusable care equipment must be cleaned and, where required, disinfected following use and before use by another resident. Where equipment is dedicated to a resident during a period of enhanced infection-control precautions, it must be appropriately decontaminated before being returned to general use.

Following the end of isolation or Transmission Based Precautions for an active MRSA infection, the resident’s room and relevant reusable equipment must receive appropriate terminal or deep cleaning before normal arrangements resume.

Cleaning and housekeeping staff must receive infection prevention and control instruction and training appropriate to their responsibilities, including the safe preparation and use of cleaning and disinfection products, management of contaminated equipment and linen, use of PPE and action to take following spillages.

Cleaning standards must be monitored through the service’s infection prevention and control audit arrangements and any identified shortfalls must be addressed promptly.

3.8 Managing MRSA in Staff and Visitors

Staff who have a confirmed MRSA infection or who have been advised by a healthcare professional that their MRSA status may affect their work must inform the appropriate manager in accordance with the service’s occupational health and sickness procedures. Confidentiality must be maintained.

A staff member must not automatically be excluded from work solely because they are colonised with MRSA. Where there is concern that a staff member may present a transmission risk, particularly where they have an active skin infection, infected lesion or other relevant condition, an individual occupational health and infection-control risk assessment must be undertaken and appropriate professional advice obtained. Any restriction from particular duties or exclusion from work must be proportionate to the identified risk and must follow advice from Occupational Health, the staff member’s treating clinician, the Infection Prevention and Control Team or Health Protection Team as appropriate.

Staff must comply with Standard Infection Control Precautions at all times and with any additional precautions identified following risk assessment. Staff undergoing prescribed treatment or decolonisation must follow the instructions of the responsible healthcare professional.

Visitors must not be restricted from visiting solely because a resident or visitor is known to be colonised with MRSA. Visitors must be given appropriate hand-hygiene information and encouraged to clean their hands as advised.

Visitors are not routinely required to wear PPE simply because a resident is colonised with MRSA. Where a visitor is providing hands-on personal care or undertaking an activity that creates an exposure risk, appropriate PPE and hand-hygiene advice must be provided in accordance with the same infection prevention and control principles applied to the activity.

Where a visitor has an active infection or another condition that may create a particular risk to a resident, especially a highly vulnerable resident, individual advice must be sought and proportionate precautions agreed. Any restriction must be based on the assessed infection risk rather than MRSA status alone.

3.9 Communication, Confidentiality and Statutory Reporting

Information about a resident’s MRSA colonisation or infection is confidential health information and must be handled in accordance with applicable data-protection, confidentiality and information-governance requirements.

The resident must be given appropriate information about their MRSA status, what this means for them, any treatment or precautions required and how they can reduce the risk of transmission. Information must be provided in a form and manner appropriate to the resident’s communication needs and level of understanding.

Information may be shared with the resident’s family or representative with the resident’s consent or where the representative has lawful authority to receive the information. Where the resident lacks capacity to make the relevant decision, information must only be shared where this is lawful, necessary and consistent with the Mental Capacity Act 2005 and the resident’s best interests. Information must not automatically be disclosed to relatives merely because the resident has MRSA.

Relevant information about MRSA infection or colonisation must be communicated to healthcare professionals involved in the resident’s care where necessary for safe treatment and continuity of care. Where a resident is transferred or referred to another health or social care provider, relevant infection-status information must be communicated to the receiving service in accordance with information-governance requirements so that appropriate precautions can be put in place.

Where an outbreak or suspected outbreak occurs, the manager or delegated competent person must contact the appropriate local Health Protection Team or Infection Prevention and Control Team without delay and follow the advice provided regarding investigation, screening, treatment, infection-control measures and outbreak management.

In accordance with Regulation 60 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended, and Schedule 3 to those Regulations, the service provider must notify Care Inspectorate Wales of the outbreak of any infectious disease.

The notification to Care Inspectorate Wales must:

A record must be maintained of the outbreak, professional advice received, statutory notifications made, infection prevention and control measures implemented and subsequent outcome.

Where the care home provides accommodation to children, the additional notification requirements contained in Schedule 3 to the Regulations must also be followed, including notification of an infectious disease outbreak to the relevant placing authority and Local Health Board where applicable.

3.10 Incident and Outbreak Management

Where two or more potentially linked cases of MRSA infection, unexpected transmission of MRSA, or any other circumstances suggest that an outbreak or significant transmission event may be occurring, the manager must seek prompt advice from the local Health Protection Team or Infection Prevention and Control Team. The service must follow the case definition, investigation arrangements and outbreak-control measures advised by the relevant health protection professionals.

Immediate action must be proportionate to the assessed transmission risk and may include:

MRSA colonisation alone must not result in automatic isolation or restriction from communal activity. Decisions concerning isolation, cohorting or restriction of movement must be based upon individual and outbreak risk assessment and relevant infection prevention and control advice.

Where an outbreak is identified, the service must make the statutory notification to Care Inspectorate Wales without delay in accordance with Regulation 60 and Schedule 3, as set out in Section 3.9 of this policy. The local Health Protection Team must also be informed and its advice followed.

The manager must ensure that a contemporaneous outbreak record is maintained. This must include the residents and staff affected where relevant, dates of onset or identification, symptoms and clinical information where appropriate, laboratory results, infection prevention and control actions, professional advice received, communications, statutory notifications and the date on which the outbreak is considered closed.

Following an outbreak, the service must review the incident to identify lessons learned and any required improvements to infection prevention and control practice. Actions arising from the review must be documented, allocated to a responsible person and monitored to completion.

4. Related Policies

This policy should be read in conjunction with the following:

5. Policy Review

This policy will be reviewed annually or sooner if there are changes in legislation, CIW guidelines, or operational requirements. Updates will be communicated to all staff, who will be required to acknowledge their understanding and compliance with the revised procedures.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.

Leave a Reply

Your email address will not be published. Required fields are marked *