Patients who receive health care outside of the U.S. or Canada, are at greater risk to be colonized with carbapenemase-producing organisms (CPOs) and Candida auris (C. auris). Both CPOs and C. auris can cause asymptomatic colonization in patients. This can lead to transmission in health care facilities if the appropriate infection control measures are not taken. It is important to initiate hospital admission screening to rapidly identify and immediately implement infection control measures for patients colonized with CPOs or C. auris. This is key to controlling the spread.
Update to the Exposures/Travel Status/Immunizations Section of the Admission Assessment-Inpatient PowerForm
The question for screening patients who may have received health care outside of the United States or Canada has been updated.
If Yes is selected, further documentation is required:
- Document when, where, and reason for stay in the free text field.
- Select the appropriate precautions.
Note: A notification is sent to Infection Prevention & Control (IPC) and to the attending provider.
Nursing Process
If the answer to the exposure question is Yes, nursing does the following:
- Places patient in contact precautions.
- Once the provider has entered the lab orders, call lab for test kit.
Note: Samples must be obtained using the Minnesota Department of Health (MDH) kit. - Provide informational handout to family (contact provider if family resistant).
○ A link to the education handout is located in the lab order or in the Admission Assessment PowerForm. - Collect two swabs
- Link to the collection information can be found on the lab order.
- Send test kit to lab in the tube system once specimen collected.
- Provider receives alert upon opening the chart.
- Follow the prompting in the alert to place lab orders for:
○ Carbapenemase-producing Organism Screening (MDH)
○ Candida auris Colonization Screening (MDH) - Ensure Contact Precaution order is placed.
- If lab orders are not placed, a second alert will display when attempting to sign additional orders.
Note: Lab orders can be ordered directly from the alert by selecting the check boxes.
- Results will be sent to:
○ Ordering provider
○ Children’s MN lab
○ Minnesota Department of Health
Note: MDH will notify IPC. - If the result is positive, provider to consult with Infectious Disease for a plan of care.
Go to the Infection Prevention & Control Star Net page for further information:
https://starnet.childrenshc.org/departments-and-committees/infection-prevention-and-control/
Effective October 18, 2022