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Contact precautions linked to provider hand hygiene

Monday December 24, 2012
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Contact precautions increased compliance with hand hygiene upon exit of isolated patientsí rooms, researchers reported.

Contact precautions are infection control measures that require patients to be isolated in their own room or grouped with patients colonized or infected with the same multidrug-resistant organism. Healthcare workers and visitors must wear gloves, gowns and other protective equipment while with a patient on contact precautions.

Over a 19-month period, researchers conducted a prospective cohort study observing healthcare worker activity at four acute-care hospitals in the United States. Trained observers monitored healthcare worker activities during routine care using a standardized collection tool and fixed one-hour observation periods.

Contact precautions were found to influence the actions of healthcare workers. Patients on contact precautions had 36.4% fewer visits from healthcare workers (2.78 visits per hour for patients on contact precautions and 4.37 visits per hour for those not on precautions). The difference was most evident among physicians and other providers, but less so among nurses.

Importantly, the researchers said, healthcare workers were 15.8% more likely to perform hand hygiene upon exiting isolated patientsí rooms.

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

"Our study shows that contact precautions for patients with drug-resistant infections modifies the care they receive," Daniel J. Morgan, MD, MS, a lead author of the study and assistant professor at the University of Maryland School of Medicine, said in a news release.

"Fewer visits and increased hand hygiene are important in preventing the spread of healthcare-associated infections, but clinicians and epidemiologists need to consider both the positive and negative aspects of these interventions, including the effect on patientsí mental well-being and perception of care."

Past studies have linked contact precautions with adverse health events in patients such as development of delirium, increased risk of falls and pressure ulcers, the researchers noted.

The study appears in the January issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America, and is available via subscription or purchase at http://bit.ly/SOEtGI.


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