Infection Control & Hospital Epidemiology

Research Briefs

Patients under Contact Precautions Have an Increased Risk of Injuries and Medication Errors A Retrospective Cohort Study

Surendra Karkia1, Karin Ledera1 and Allen C. Chenga1a2 c1

a1 Department of Epidemiology and Preventive Medicine, Infectious Disease Epidemiology Unit, Monash University, Melbourne, Victoria, Australia

a2 Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, Prahran, Victoria, Australia

Contact precautions (CPs) may lead to adverse psychological effects, delays in access to services, and compromises in the quality of care and patient safety. These need to be balanced with the benefits in preventing transmission of resistant microorganisms. In this study, we aimed to quantify the effect of CPs on reported patient safety incidents.

The Alfred hospital is a tertiary referral hospital in Melbourne, Australia. Previous studies have shown that colonization with vancomycin-resistant enterococcus (VRE) is endemic in our hospital. Patients found to be colonized with VRE are placed in CPs immediately and during each subsequent admission. At our facility, modified CPs practiced during the study period include isolation in single rooms with a dedicated toilet, use of gloves when entering the room, and gloves and gown if contact with body fluids is anticipated. The hospital has a computerized risk management system where relevant patient safety incidents are reported to facilitate institutional review and response. We conducted a retrospective cohort study using these routinely collected data, comparing the incidence rate of documented adverse events in patients prior and subsequent to initiation of CPs among patients colonized or infected with VRE. Patients with incident VRE detection between January 2009 and October 2010 were included.

(Received April 16 2013)

(Accepted June 18 2013)

Correspondence

c1 Department of Epidemiology and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, Victoria 3004, Australia (allen.cheng@monash.edu)