Information for School Nurses

Methicillin-resistant Staphylococcus Aureus (MRSA) is a type of staph that is resistant to certain antibiotics. These antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin and amoxicillin. Staph infections, including MRSA, occur most frequently among persons in hospitals and healthcare facilities (such as nursing homes and dialysis centers) who have weakened immune systems (CDC).

Guidelines for the school health team (courtesy of Tacoma-Pierce Health Department):

School/Nurse Responsibility

  1. Report to your local health jurisdiction is not required. Although, if a cluster of two or more cases occurs in a single classroom or athletic team, please notify your local health department.
  2. Students with skin infections may need to be referred to a licensed health care provider for diagnosis and treatment. School health personnel should notify parents/guardians when possible skin infections are detected.
  3. Use standard precautions (e.g., hand hygiene before and after contact, wearing gloves) when caring for nonintact skin or potential infections.
  4. Use barriers such as gowns, masks and eye protection if splashing of body fluids is anticipated.

Control of Spread

  1. Students or staff members, who are colonized or infected with MRSA, do not need to be routinely excluded from the classroom.
  2. Exclusion from school should be reserved for those with wound drainage that cannot be covered and contained with a clean, dry dressing.
  3. Athletes with active skin and soft tissue infections should not participate in wrestling until wounds are completely healed. Consider using this rule for all contact sports.
  4. Individuals with open wounds should keep them covered with clean, dry bandages that are taped on all four sides.
  5. Gloves should be worn if you expect to have contact with non-intact skin or mucous membranes. Hands should be washed immediately after removing gloves.
  6. Good personal hygiene and hand washing with soap and water for at least 20 seconds should be encouraged.
  7. If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol concentration.
  8. Potentially contaminated surfaces should be cleaned with an EPA-registered disinfectant labeled effective against MRSA and manufacturers directions should be followed. Household bleach diluted 1:100 (new solution every day) may be used.
  9. Clean and disinfect health room cots regularly (at least daily), and use pillow protectors. See "Quick Reference Environmental Cleaning for School Nurses" handout.
  10. If soiled linens and clothing are washed on school premises, wash with laundry detergent in hot water (minimum 160oF), add one cup of bleach if water is not 160oF and dry in a hot dryer.

Special Considerations in Sport Settings

Refer to Information for Athletic Centers