1. Educating the Athletic Community about MRSA Presentation for Hawaii Athletic Trainers’ Association August 2009

2. Why bother? BOC STANDARDS OF PROFESSIONAL PRACTICE STATE: The BOC does not express an opinion on the competence or warrant job performance of credential holders; however, every Athletic Trainer and applicant must agree to comply with the Standards at all times. Standard 1: Direction The Athletic Trainer renders service or treatment under the direction of a physician. Standard 2: Prevention The Athletic Trainer understands and uses preventive measures to ensure the highest quality of care for every patient.

3. WHY BOTHER?

4. Because… 17 year old wrestler Noah A. Developed flu like symptoms following wrestling camp in Lake Arrowhead, CA June 2008 17 year old wrestler Noah A. Developed flu like symptoms following wrestling camp in Lake Arrowhead, CA June 2008 PMD suspected chicken pox PMD suspected chicken pox Noah developed pneumonia Noah developed pneumonia Died July 20, 2008 Died July 20, 2008

5. Because….

6. Saleen Jones, 17 year old cornerback at Martin Luther King High school in Philadelphia died Sept 27, 2008 from MRSA Saleen Jones, 17 year old cornerback at Martin Luther King High school in Philadelphia died Sept 27, 2008 from MRSA No visible signs of MRSA infection No visible signs of MRSA infection Went to hospital with neck pain, initially ER staff suspected head injury Went to hospital with neck pain, initially ER staff suspected head injury

7. Other newsmakers Ryan Robinson, junior soccer player Jessamine High School Ky Died 2008 Ryan Robinson, junior soccer player Jessamine High School Ky Died 2008 Alonzo Smith, senior Liberty HS Florida went to ER with back spasms, quad contraction and rash died Oct 2008 Alonzo Smith, senior Liberty HS Florida went to ER with back spasms, quad contraction and rash died Oct 2008 An entire county in Wisconsin suspended wrestling for one month in 2007 due to “widespread MRSA” An entire county in Wisconsin suspended wrestling for one month in 2007 due to “widespread MRSA”

8. Why bother? 2007—6 out of 59 high school football players diagnosed with MRSA infection after spending 4 nights sleeping in school gym for football camp. 2007—6 out of 59 high school football players diagnosed with MRSA infection after spending 4 nights sleeping in school gym for football camp. Although athletes were offered laundry service most never washed the towels they brought into camp. Although athletes were offered laundry service most never washed the towels they brought into camp. Athletes shared towels, soap, and razors Athletes shared towels, soap, and razors

9. Why bother… Infectious Disease News reported in May 2007 that 53% of Certified Athletic Trainers surveyed, reported treating a MRSA infection within the past year. Infectious Disease News reported in May 2007 that 53% of Certified Athletic Trainers surveyed, reported treating a MRSA infection within the past year. 21 schools were closed in Virginia after a Bedford high school senior died from MRSA complication in 2008 21 schools were closed in Virginia after a Bedford high school senior died from MRSA complication in 2008

10. PREVENTION THROUGH EDUCATION “It is much easier to cure what you never had in the first place” “It is much easier to cure what you never had in the first place” Sam the flim flam man

11. Who to educate Student Athletes Student Athletes Coaches Coaches Administrators Administrators Parents Parents Equipment Managers Equipment Managers Janitorial/custodial staff Janitorial/custodial staff

12. How? Know your audience; know what appeals to them and what their attention span is. Know your audience; know what appeals to them and what their attention span is. Know where you present Know where you present –At practice field, gym, court –Classrooms, auditoriums etc Today’s Students are visual learners, your medium for presenting depends on your site Today’s Students are visual learners, your medium for presenting depends on your site

13. Who do you think has the shortest attention span? Students? Students? Parents? Parents? Coaches? Coaches? Administrators? Administrators? Staff? Staff?

14. Educating students SCARE THEM!!! SCARE THEM!!! Put posters in Athletic Training Room, locker rooms, bulletin boards Put posters in Athletic Training Room, locker rooms, bulletin boards Show them pictures, power points, videos Show them pictures, power points, videos Tell them there is a podcast Tell them there is a podcast Tell them how to clean and to keep wounds covered Tell them how to clean and to keep wounds covered Make sure they clean equipment and personal items like knee/elbow pads Make sure they clean equipment and personal items like knee/elbow pads Teach them to STOP SHARING Teach them to STOP SHARING

15. EDUCATING PARENTS TAP THEIR EMOTIONS TAP THEIR EMOTIONS I start with picture of Saleen Jones I start with picture of Saleen Jones Tell them what they can do at home Tell them what they can do at home Tell them signs and symptoms that warrant MD visit Tell them signs and symptoms that warrant MD visit Reassure them what you, your employer do to prevent and control MRSA Reassure them what you, your employer do to prevent and control MRSA

16. EDUCATING ADMINISTRATORS REASSURE THEM REASSURE THEM Tell them the steps you and your athletic staff take to prevent infection ie. Tell them the steps you and your athletic staff take to prevent infection ie. –Disinfection controls :Mop floors, disinfect treatment tables (often), disinfectant in whirlpools, wash towels and uniforms in hottest water safe for fabric, wash hands –Cleanse and bandage all wounds daily –Refer to MD when any symptoms arise –Tell them you are trying to educate your coaches,students, and parents –Communicate with school nurse/health center

17. EDUCATING COACHES SHOCK THEM!! SHOCK THEM!! Put Newspaper clippings in their locker room, mailbox, or clipboard Put Newspaper clippings in their locker room, mailbox, or clipboard Highlight the part where the coaches are quoted Highlight the part where the coaches are quoted Make sure they know all skin wounds have high risk Make sure they know all skin wounds have high risk Make sure they have first aid supplies at practice Make sure they have first aid supplies at practice Tell them to encourage players to shower immediately after practice and not to share soap or towels Tell them to encourage players to shower immediately after practice and not to share soap or towels

18. EDUCATING SCHOOL STAFF MATTER OF FACT MATTER OF FACT TELL THEM EXACTLY WHAT THEY NEED TO DO TO PREVENT OR MINIMIZE OUTBREAK TELL THEM EXACTLY WHAT THEY NEED TO DO TO PREVENT OR MINIMIZE OUTBREAK Give them CDC guidelines Give them CDC guidelines Make sure coaches and equipment staff wear gloves while handling laundry Make sure coaches and equipment staff wear gloves while handling laundry

19. Great Resources CDC www.cdc.gov Click on MRSA education materials CDC www.cdc.gov Click on MRSA education materialswww.cdc.gov They have lots of downloads, posters, handouts, powerpoints, podcasts. They have lots of downloads, posters, handouts, powerpoints, podcasts. All are reproducible and free. You may also order full size posters. The power point is from 2004 and can be edited. All are reproducible and free. You may also order full size posters. The power point is from 2004 and can be edited.

20. CDC handouts: There are differing headers to this handout There are differing headers to this handout

26. MRSA: Implications in Sports Medicine Staphylococcus aureus, often referred to as “staph”, are bacteria commonly carried on the skin or in the nose of healthy people Staphylococcus aureus, often referred to as “staph”, are bacteria commonly carried on the skin or in the nose of healthy people

27. Resources Hibicleans Hibicleans They have posters, handouts, video/DVDs They have posters, handouts, video/DVDs

28. Resources NATA www.nata.org NATA www.nata.org www.nata.org Best practices statement Best practices statement

29. Resources Hawaii State Department of Health Hawaii State Department of Health www.hawaii.gov/health www.hawaii.gov/health www.hawaii.gov/health There is one handout but not much else There is one handout but not much else

30. Poster from State Department of Health

31. Resources www.mrsaresouces. com www.mrsaresouces. com www.mrsaresouces. com www.mrsaresouces. com They have a printable, customizable, tri- fold brochure written at student level They have a printable, customizable, tri- fold brochure written at student level

32. Summary Use a variety of materials Use a variety of materials Leave a handout after you finish speaking Leave a handout after you finish speaking Try to keep to 15 minutes or less Try to keep to 15 minutes or less

33. Questions????????????? Mahalo