5-11/070.00 Guidelines for Limiting the Possibility of Infection by Methicillin Resistant Staphylococcus Aureus (MRSA)

Methicillin Resistant Staphylococcus Aureus (MRSA) is a resistant bacterial infection that can be spread in housing areas, such as the Los Angeles County Jails. Since this infection can be spread rapidly through touch and/or sharing of personal items (such as towels, sheets, razors, etc.) it is important for custody personnel to understand its infectious nature. The following guidelines will assist personnel in reducing and preventing the transmission of MRSA to employees, family members, and inmates.

It shall be the responsibility of the Inmate Reception Center unit commander to ensure that all inmates view the MRSA training video.

Correctional Health Services (CHS) personnel are responsible for identifying and treating cases of MRSA. However, when custody personnel suspect any symptoms of MRSA, they shall advise Medical Services staff immediately.

Personnel should understand that frequent hand-washing and the use of hand sanitizers are essential infection control components. Personnel should be washing their hands:

• After contact with inmates
• After searching inmate housing areas
• Prior to starting a break
• Prior to eating
• Prior to leaving the facility

In order to limit the spread of MRSA, personnel should encourage all inmates to do the following:

• Inmates who develop boils, wounds that resemble spider bites, and skin infections should be directed to the medical clinic as soon as possible to be evaluated
• Inmates should refrain from having other inmates pop boils or skin lesions, or share items including bedding, clothing, and toiletries
• Inmates should improve personal hygiene by hand washing and using soap
• Inmates should shower frequently (daily if possible) especially in those cells and housing areas where there is an active case of MRSA

Personnel shall ensure that soap is available for use by inmates.

Once an inmate has been identified with MRSA, CHS personnel shall provide custody personnel the name and booking number. Inmates housed with an infected inmate shall be evaluated by CHS personnel. The area in which the inmate was housed shall be vacated until the area is cleaned.

Once the cell is no longer occupied, custody personnel shall ensure that the cell is thoroughly cleaned with an EPA approved antimicrobial cleaner. Personnel shall exercise caution when handling caustic chemicals. The area cleaned shall include the sinks, beds, toilets, walls, and showers. Mattresses shall be removed and cleaned as well. Those mattresses that are torn or have any cuts in them shall be discarded. If two or more cases of MRSA are discovered in the same dorm/housing area within one month, the entire dorm/housing area shall be thoroughly cleaned as noted above.

Upon diagnosis with MRSA, inmates shall receive a shower, a complete change of linen, and jail clothing; including jump suits, underwear, socks, sheets, towels, and blankets. This should occur on the same day as the cleaning of the housing area prior to returning any inmates to the area.

While an inmate is being treated for MRSA, inmates and staff should be aware of the possibility of infections caused by touching or handling soiled bandages. All bandages shall be removed and destroyed by CHS personnel. Custody personnel shall exercise appropriate sterile procedures and avoid touching bandages. Additionally, infected inmates shall have the frequency of jail clothing, underwear, and linen exchanges increased.

Per the Manual of Policy and Procedures section 3-02/040.05, “Occupational Injury/Illness,” personnel who believe they have become infected with MRSA shall “report the circumstances to his supervisor as soon as possible.” All other procedures regarding the injury/illness shall be followed in compliance with Department and Divisional policies and procedure.