Study: Contact Precautions Shown to Impact Patient Care

December 11, 2012

A new study published in the January issue of Infection Control and Hospital Epidemiology (ICHE) shows that contact precautions, a common prevention method for patients with difficult to treat infections, can have both positive and negative impacts on patient care.

Contact precautions are specific infection control measures requiring the isolation of patients in private rooms or grouped with other patients colonized or infected with the same type of multi-drug resistant organism.  When a patient is under contact precautions, healthcare workers and visitors are required to wear gloves, gowns, and other protective equipment while visiting or caring for the patient.

Specifically, the study researchers found when patients with methicillin-resistant Staphylococcus aureus (MRSA) and other antibiotic-resistant bacteria were isolated under contact precautions, hand hygiene compliance upon exiting the patients’ rooms increased, however visits by healthcare workers and outside visitors decreased.

According to a press release about the study issued by the Society for Healthcare Epidemiology of America (SHEA):

Over a 19-month period, researchers conducted a prospective cohort study observing healthcare worker activity at four acute-care hospitals in the United States where trained observers performed “secret shopper” monitoring of healthcare worker activities during routine care using a standardized collection tool and fixed 1-hour observations periods.

Contact precautions were found to influence the actions of healthcare workers. Patients on contact precautions had 36.4 percent fewer visits from healthcare workers (2.78 visits/hour for patients on contact precautions and 4.37 visits/hour for those not on precautions). The difference was most evident among physicians and other providers, but less so in nurses. Importantly, healthcare workers were 15.8 percent more likely to perform hand hygiene upon exiting isolated patients’ rooms.

The frequency of visitors was also impacted by contact precautions with 23 percent fewer visitors for patients on precautions.

“Our study shows that contact precautions for patients with drug resistant infections modifies the care they receive,” said Daniel J. Morgan, MD, MS, a lead author of the study. “Fewer visits and increased hand hygiene are important in preventing the spread healthcare-associated infections, but clinicians and epidemiologists need to consider both the positive and negative aspects of these interventions, including the effect to patients’ mental wellbeing and perception of care.”

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