Contact precautions: More is not necessarily better

Sorabh Dhar, Dror Marchaim, Ryan Tansek, Teena Chopra, Adnan Yousuf, Ashish Bhargava, Emily T. Martin, Thomas R. Talbot, Laura E. Johnson, Ameet Hingwe, Jerry M. Zuckerman, Bartholomew R. Bono, Emily K. Shuman, Jose Poblete, Maryann Tran, Grace Kulhanek, Rama Thyagarajan, Vijayalakshmi Nagappan, Carrie A Herzke, Trish M. PerlKeith S. Kaye

Research output: Contribution to journalArticle

Abstract

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 p.03) and in noncompliance with hand hygiene prior to donning gowns and gloves (OR, 10.1 [95% CI, 1.84-55.54]; P 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.

Original languageEnglish (US)
Pages (from-to)213-221
Number of pages9
JournalInfection Control and Hospital Epidemiology
Volume35
Issue number3
DOIs
StatePublished - Mar 2014

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Hand Hygiene
Delivery of Health Care
Odds Ratio
Confidence Intervals
Patients' Rooms
Teaching Hospitals
Compliance
Cohort Studies
Outcome Assessment (Health Care)
Prospective Studies

ASJC Scopus subject areas

  • Microbiology (medical)
  • Epidemiology
  • Infectious Diseases
  • Medicine(all)

Cite this

Dhar, S., Marchaim, D., Tansek, R., Chopra, T., Yousuf, A., Bhargava, A., ... Kaye, K. S. (2014). Contact precautions: More is not necessarily better. Infection Control and Hospital Epidemiology, 35(3), 213-221. https://doi.org/10.1086/675294

Contact precautions : More is not necessarily better. / Dhar, Sorabh; Marchaim, Dror; Tansek, Ryan; Chopra, Teena; Yousuf, Adnan; Bhargava, Ashish; Martin, Emily T.; Talbot, Thomas R.; Johnson, Laura E.; Hingwe, Ameet; Zuckerman, Jerry M.; Bono, Bartholomew R.; Shuman, Emily K.; Poblete, Jose; Tran, Maryann; Kulhanek, Grace; Thyagarajan, Rama; Nagappan, Vijayalakshmi; Herzke, Carrie A; Perl, Trish M.; Kaye, Keith S.

In: Infection Control and Hospital Epidemiology, Vol. 35, No. 3, 03.2014, p. 213-221.

Research output: Contribution to journalArticle

Dhar, S, Marchaim, D, Tansek, R, Chopra, T, Yousuf, A, Bhargava, A, Martin, ET, Talbot, TR, Johnson, LE, Hingwe, A, Zuckerman, JM, Bono, BR, Shuman, EK, Poblete, J, Tran, M, Kulhanek, G, Thyagarajan, R, Nagappan, V, Herzke, CA, Perl, TM & Kaye, KS 2014, 'Contact precautions: More is not necessarily better', Infection Control and Hospital Epidemiology, vol. 35, no. 3, pp. 213-221. https://doi.org/10.1086/675294
Dhar S, Marchaim D, Tansek R, Chopra T, Yousuf A, Bhargava A et al. Contact precautions: More is not necessarily better. Infection Control and Hospital Epidemiology. 2014 Mar;35(3):213-221. https://doi.org/10.1086/675294
Dhar, Sorabh ; Marchaim, Dror ; Tansek, Ryan ; Chopra, Teena ; Yousuf, Adnan ; Bhargava, Ashish ; Martin, Emily T. ; Talbot, Thomas R. ; Johnson, Laura E. ; Hingwe, Ameet ; Zuckerman, Jerry M. ; Bono, Bartholomew R. ; Shuman, Emily K. ; Poblete, Jose ; Tran, Maryann ; Kulhanek, Grace ; Thyagarajan, Rama ; Nagappan, Vijayalakshmi ; Herzke, Carrie A ; Perl, Trish M. ; Kaye, Keith S. / Contact precautions : More is not necessarily better. In: Infection Control and Hospital Epidemiology. 2014 ; Vol. 35, No. 3. pp. 213-221.
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