The hidden criminal: How to keep MRSA bacteria locked out

Educating inmates and staff on infection prevention, while also adhering to basic hygiene principles, can reduce the potential for MRSA outbreaks


Methacillin resistant staphylococcus aureus (MRSA) is a bacteria that has mutated to resist the effects of our usual antibiotic arsenal. This makes it very dangerous. Although staphylococcus aureus (staph) bacteria normally inhabits the human skin, the less-common MRSA strain can cause stubborn infections of open cuts and wounds. Treatment can be severe and expensive. While MRSA outbreaks were once limited to the hospital setting, community-associated MRSA is on the rise in close communities like correctional facilities. This concern cannot be ignored.

News reports of major outbreaks in state prison systems and county jails can make everyone nervous. Corrections officers have well-founded concerns about taking the bacteria home to their families. However, adhering to basic hygiene principles can reduce the potential for these concerns to become reality.

This 2005 photograph depicted a cutaneous abscess on the knee of a prison inmate, which had been caused by methicillin-resistant Staphylococcus aureus bacteria, referred to by the acronym MRSA. (CDC photo)
This 2005 photograph depicted a cutaneous abscess on the knee of a prison inmate, which had been caused by methicillin-resistant Staphylococcus aureus bacteria, referred to by the acronym MRSA. (CDC photo)

In February, the Federal Bureau of Prisons released their updated MRSA Clinical Practice Guidelines — it contains many helpful tips for decreasing the chances for a MRSA outbreak at your facility. Although much of the 36-page document is specific for medical treatment guidelines, several important points are offered for custody management and staff.

Enemy Surveillance
Be vigilant for MRSA at all ports of entry into your facility. Skin inspection for infection should take place at intake and any point of inmate relocation. Any potential infection should be medically evaluated and containment measures taken until a determination is made.

Be suspicious of all skin conditions — MRSA skin infections often look like boils or spider bites.

Take Precautions
Standard precautions, that is. Use gloves during shakedowns and cell searches. Be sure to have the supplies you need before you start — such as leak-proof bags — to transport potentially infected personal items. Take hand washing seriously and encourage your peers and inmates to do the same. It is the single most important preventative action. Don’t forget the fingernails and thumbs, as they are the most often missed areas.

Keep it Clean
MRSA can live for short periods on equipment and personal items. A recently published study of the microbe on common jail surfaces noted such locations as the stair railing in inmate housing and cracked transport van seating. Be sure surfaces are regularly cleaned with appropriate strength disinfectant solutions.

No PC
Personal contact is detrimental. Inmates sharing towels, razors and other personal items can spread the infection — as can inmate actions like lancing boils and prison tattooing. Reduce these practices in your cellblocks. Be sure the temperature of the laundry water is high enough to kill bacteria (including home laundering of officer uniforms).

Educate to Eradicate
MRSA and other infection prevention should be a regular part of staff and inmate education. Some states, like Massachusetts, created officer and inmate fact sheets that can help reinforce education efforts. But don’t rely solely on passing out fact sheets that might be tossed aside or disregarded. Regularly review points during shift reports, staff meetings and incident debriefs. Incorporate this information into inmate orientation and cellblock meetings.

MRSA can be difficult to eradicate once it invades your facility. Taking these measures can keep MRSA locked out of your workplace.

About the author

Dr. Schoenly has been a nurse for 30 years and is currently specializing in correctional healthcare. She is an author and educator seeking to improve patient safety and professional nursing practice behind bars. Her web-presence, Correctional Nurse, provides information and support to those working in correctional health care. Her books, Essentials of Correctional Nursing and The Correctional Health Care Patient Safety Handbook are available in print and digital on amazon.

Follow on Twitter: www.twitter.com/lorryschoenly

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Blogging @ www.correctionalnurse.net

Professional Details @ www.linkedin.com/in/lorryschoenly

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