Hydrotherapy and MRSA ??

[Wrigglyb]

Hello,
Does anyone have any policies or guidelines for hydrotherapy regarding clients/patients who have known MRSA in either sputum or wounds?
From an infection control point of view could there be any concerns, or is it assumed that the chlorine kills most bugs?? - even MRSA??
The other issue, more with a productive MRSA infected cough - what would your opinion be on supporting clients within a hydro pool (in close proximity) - is there an unneccesary risk of infection to the person supporting - what precautions do you think might be acceptable?
Thanks very much for your comments/advice!!
Rebecca (UK)

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[HoJoPT]

I would say that practising universal precautions in a pool would be almost impossible. My take would be not to take the patient into the pool unless their MRSA is colonized and stable (ie, non-infectious). It would be a good question to address with a Director of Nursing or a Physician. Great question for us all. Good luck

[chp4211]

I used to run a hydro pool and though there was no specific policy regarding MRSA clients our first step was to seek medical clearance (ie: from GP) prior to attending hydro and from there observing standard infection control procedures. Patients with wounds weren't allowed in the pool without a suitable waterproof dressing in any case. Most times we would be extra cautious by either isolating the patient in the pool and/or ensuring that they were in the last session of the day.

Also, I haven't had the pleasure of having to deal with MRSA sputum but a CNC colleague suggested masking for patient and practitioner might take care of most droplets - might make clearance and/or collection a little tricky though...

Cheers, Ray

[neurospast]

I would like to suggest to contact infection control because as far as I can see: We, physiotherapsits have absolutely no clue about infections and should admit that.

[neving]

re contact infection control, you can get a full face - clear plastic - mask which will also protect your eyes, ask on the ward, they should have them (I work in a mental hospital and our patients are known to spit....)
neving

[Wrigglyb]

Thanks for the replies - food for thought!!
I have continued to ask the professionals that I work with about this topic and ironically it is the infection control lead nurse and GP that say it is fine, no problem, no real need for any additional protection other than any precautions you would normally take on dry land - BUT known MRSA patients/clients generally are in isolation, plinths/equipment are supposed to be wiped down and cleaned following use..........how feasible is this in a pool environment when you consider changing/transfering into a pool!?!? With secretions being MRSA+ coughs are capable of transfering the bug pretty much anywhere - but infection control say this is ok!?!? and no risk to the other medically vulnerable adults or children who use the pool at other times?!
Part of the problem is perhaps that I work within the community setting where MRSA is often swept under the carpet with the attitude *we can't do anything about it*. I'm not a big fan of the word can't )
Anyway....thanks for your interest!