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This form is used for the surveillance of Methicillin-Resistant Staphylococcus aureus (MRSA) cases isolated from normally sterile sites, collecting essential patient and infection information.
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How to fill out mrsa surveillance supplemental form

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How to fill out MRSA Surveillance Supplemental Form

01
Start by gathering information about the patient, including their name and medical record number.
02
Fill in the date of the specimen collection.
03
Indicate the source of the specimen, such as nasal swab or wound culture.
04
Record the results of the MRSA test, specifying whether it was positive or negative.
05
Provide details about the patient's relevant medical history, including previous MRSA infections.
06
Include information on any antibiotic treatment the patient is currently receiving.
07
Ensure that all required fields are completed accurately to maintain compliance.

Who needs MRSA Surveillance Supplemental Form?

01
Healthcare facilities that are conducting surveillance for MRSA infections.
02
Public health authorities monitoring the spread of MRSA.
03
Researchers studying antibiotic-resistant infections.
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However, certain factors make it easier for MRSA to spread. These are the 5 Cs: Crowding, frequent skin-to-skin Contact, Compromised skin (cut, scrape, or rash), Contaminated items and surfaces, and lack of Cleanliness.
There are two main types of MRSA: Healthcare-associated MRSA (HA MRSA) is found mainly in hospital patients and long-term care facility residents. Community-associated MRSA (CA MRSA) is found in those who have not had contact with health care facilities.
If you're concerned about a skin injury that's not getting better, be on the lookout for MRSA signs and symptoms: A Skin Lesion That Doesn't Get Better. One or More Swollen Red Bumps Draining Pus. Worse-Than-Usual Pain or Fever.
However, certain factors make it easier for MRSA to spread. These are the 5 Cs: Crowding, frequent skin-to-skin Contact, Compromised skin (cut, scrape, or rash), Contaminated items and surfaces, and lack of Cleanliness.
A MRSA test looks for MRSA bacteria in a sample of fluid or tissue from your body. The sample is often taken from your nose or a wound. MRSA stands for methicillin-resistant Staphylococcus aureus. It is a type of staph bacteria. Many people have MRSA or other staph bacteria living on their skin or in their noses.
Cleaning and Disinfection ProductEPA reg. no.Contact/Wet Time (S. aureus and MRSA) Clorox ® Clean-Up ® Disinfectant Cleaner with Bleach1 67619-17 30 sec Clorox Healthcare ® Hydrogen Peroxide Cleaner Disinfectant Wipes 67619-25 1 min Clorox Healthcare ® Hydrogen Peroxide Cleaner Disinfectant 67619-24 1 min15 more rows
For example, the hospital antibiogram can be used to identify the proportion of S. aureus isolates that are methicillin-resistant. Most hospital laboratories produce an antibiogram at least once per year and thus these can be helpful in identifying changes in the prevalence of MRSA over time.

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The MRSA Surveillance Supplemental Form is a document used to collect data regarding cases of Methicillin-Resistant Staphylococcus aureus (MRSA) infections within a healthcare setting to monitor and control the spread of this antibiotic-resistant bacterium.
Healthcare facilities, including hospitals and long-term care facilities, that report MRSA infection data to public health authorities are required to file the MRSA Surveillance Supplemental Form.
To fill out the MRSA Surveillance Supplemental Form, healthcare providers must provide patient demographic information, details of the MRSA infection, laboratory test results, and any relevant treatment information, ensuring that all sections of the form are accurately completed.
The purpose of the MRSA Surveillance Supplemental Form is to systematically gather and report data on MRSA cases to enhance surveillance, inform public health initiatives, and improve infection prevention and control measures.
The information that must be reported on the MRSA Surveillance Supplemental Form includes patient identifiers, demographics, clinical details of the infection, test results indicating MRSA, treatment information, and any associated complications or outcomes.
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