Contact Precautions More Is Not Necessarily Better
| Autor: | Carrie Herzke, Ryan Tansek, Teena Chopra, Sorabh Dhar, Bartholomew R Bono, MaryAnn P Tran, Ashish Bhargava, Jerry M. Zuckerman, Rama Thyagarajan, Trish M. Perl, Ameet Hingwe, Jose E Poblete, Thomas R. Talbot, Keith S. Kaye, Laura Johnson, Dror Marchaim, Vijayalakshmi Nagappan, Grace Kulhanek, Emily K. Shuman, Emily T. Martin, Adnan Yousuf |
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| Rok vydání: | 2014 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty Patient Encounter Isolation (health care) Epidemiology media_common.quotation_subject 030106 microbiology Patient Isolation 03 medical and health sciences 0302 clinical medicine Protective Clothing Hygiene Humans Medicine Hand Hygiene Prospective Studies 030212 general & internal medicine Hospitals Teaching media_common Cross Infection business.industry Guideline adherence Outcome measures medicine.disease Surgery Personnel Hospital Patient room Infectious Diseases Contact precautions Contact isolation Guideline Adherence Medical emergency Gloves Protective business |
| Zdroj: | Infection Control & Hospital Epidemiology. 35:213-219 |
| ISSN: | 1559-6834 0899-823X |
| DOI: | 10.1086/675294 |
| Popis: | Objective.To determine whether increases in contact isolation precautions are associated with decreased adherence to isolation practices among healthcare workers (HCWs).Design.Prospective cohort study from February 2009 to October 2009.Setting.Eleven teaching hospitals.Participants.HCWs.Methods.One thousand thirteen observations conducted on HCWs. Additional data included the number of persons in isolation, types of HCWs, and hospital-specific contact precaution practices. Main outcome measures included compliance with individual components of contact isolation precautions (hand hygiene before and after patient encounter, donning of gown and glove upon entering a patient room, and doffing upon exiting) and overall compliance (all 5 measures together) during varying burdens of isolation.Results.Compliance with hand hygiene was as follows: prior to donning gowns/gloves, 37.2%; gowning, 74.3%; gloving, 80.1%; doffing of gowns/gloves, 80.1%; after gown/glove removal, 61%. Compliance with all components was 28.9%. As the burden of isolation increased (20% or less to greater than 60%), a decrease in compliance with hand hygiene (43.6%—4.9%) and with all 5 components (31.5%—6.5%) was observed. In multivariable analysis, there was an increase in noncompliance with all 5 components of the contact isolation precautions bundle (odds ratio [OR], 6.6 [95% confidence interval (CI), 1.15-37.44];P= .03) and in noncompliance with hand hygiene prior to donning gowns and gloves (OR, 10.1 [95% CI, 1.84—55.54];P= .008) associated with increasing burden of isolation.Conclusions.As the proportion of patients in contact isolation increases, compliance with contact isolation precautions decreases. Placing 40% of patients under contact precautions represents a tipping point for noncompliance with contact isolation precautions measures. |
| Databáze: | OpenAIRE |
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