Appendix C - Medical Directive 006

PATIENT IDENTIFICATION
RUH
SCH
SPH
OTHER:
ACTION
RN
REQ
ICP
MAR
Contact Tracing Surveillance Orders MD-006
Based on an individual assessment of patients who have been in contact with a patient or the
environment of a patient with a newly identified Antibiotic Resistant Organism (ARO), Infection
Control Practitioners (ICP) may order lab tests to determine if there has been nosocomial
transmission of an ARO during their stay. Licensed nurses may collect specimens based on the ICP
orders.
Lab Investigations
Day 1: Date
Methicillin Resistant Staphylococcus aureus (MRSA)
One swab to both nares AND one swab to both sides of groin
Vancomycin Resistant Enterococcus (VRE)
One rectal/stoma* swab
* If the patient has a colostomy, send a swab from the stoma opening
Extended Spectrum Beta-Lactamases (ESBL):
One perianal/stoma** swab
**If the patient has an ileostomy, send a swab from the stoma opening
Day 7: Date
Methicillin Resistant Staphylococcus aureus (MRSA)
One swab to both nares AND one swab to both sides of groin
Vancomycin Resistant Enterococcus (VRE) One rectal/stoma* swab
*If the patient has a colostomy, send a swab from the stoma opening
Extended Spectrum Beta-Lactamases (ESBL):
One perianal/stoma** swab
**If the patient has an ileostomy, send a swab from the stoma opening
This Medical Directive has been approved by the Infection Control Officers and complies with the Saskatoon
Health Region Medical Directives Policy (7311-60-027).
Review will occur every 2 years. This Directive is in effect until April 2015.
ICP Printed Name:_______________________________ ICP Signature:______________________________
DATE
Form # 103689
TIME
09/13
Category: Orders
These orders do not require a prescribing
practitioner signature
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