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The Effect of Contact Precautions on Frequency of Hospital Adverse Events

Published online by Cambridge University Press:  17 August 2015

Lindsay D. Croft ,
Michael Liquori ,
James Ladd ,
Hannah Day ,
Lisa Pineles ,
Elizabeth Lamos ,
Ryan Arnold ,
Preeti Mehrotra ,
Jeffrey C. Fink  and
Patricia Langenberg
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Lindsay D. Croft
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
Michael Liquori
Affiliation:
Department of Medicine, University of Maryland Medical Center, Baltimore, Maryland Veterans’ Affairs Maryland Healthcare System, Baltimore, Maryland
James Ladd
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
Hannah Day
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
Lisa Pineles
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
Elizabeth Lamos
Affiliation:
Department of Medicine, University of Maryland Medical Center, Baltimore, Maryland
Ryan Arnold
Affiliation:
Department of Medicine, University of Maryland Medical Center, Baltimore, Maryland
Preeti Mehrotra
Affiliation:
Division of Infectious Diseases, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts
Jeffrey C. Fink
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland Department of Medicine, Division of General Internal Medicine, University of Maryland School of Medicine, Baltimore, Maryland Veterans’ Affairs Maryland Healthcare System, Baltimore, Maryland
Patricia Langenberg
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
Linda Simoni-Wastila
Affiliation:
Department of Pharmaceutical Health Services, University of Maryland School of Pharmacy, Baltimore, Maryland
Eli Perencevich
Affiliation:
Carver College of Medicine, University of Iowa, Iowa City, Iowa Iowa City Veterans’ Affairs Health Care System, Iowa City, Iowa
Anthony D. Harris
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland Veterans’ Affairs Maryland Healthcare System, Baltimore, Maryland
Daniel J. Morgan*
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland Veterans’ Affairs Maryland Healthcare System, Baltimore, Maryland
*
Address correspondence to Daniel J. Morgan, MD, MS, Department of Epidemiology and Public Health, University of Maryland School of Medicine, 685 W. Baltimore St. MSTF 334, Baltimore, Maryland 21201 (dmorgan@epi.umaryland.edu).
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Abstract

OBJECTIVE

To determine whether use of contact precautions on hospital ward patients is associated with patient adverse events

DESIGN

Individually matched prospective cohort study

SETTING

The University of Maryland Medical Center, a tertiary care hospital in Baltimore, Maryland

METHODS

A total of 296 medical or surgical inpatients admitted to non–intensive care unit hospital wards were enrolled at admission from January to November 2010. Patients on contact precautions were individually matched by hospital unit after an initial 3-day length of stay to patients not on contact precautions. Adverse events were detected by physician chart review and categorized as noninfectious, preventable and severe noninfectious, and infectious adverse events during the patient’s stay using the standardized Institute for Healthcare Improvement’s Global Trigger Tool.

RESULTS

The cohort of 148 patients on contact precautions at admission was matched with a cohort of 148 patients not on contact precautions. Of the total 296 subjects, 104 (35.1%) experienced at least 1 adverse event during their hospital stay. Contact precautions were associated with fewer noninfectious adverse events (rate ratio [RtR], 0.70; 95% confidence interval [CI], 0.51–0.95; P=.02) and although not statistically significant, with fewer severe adverse events (RtR, 0.69; 95% CI, 0.46–1.03; P=.07). Preventable adverse events did not significantly differ between patients on contact precautions and patients not on contact precautions (RtR, 0.85; 95% CI, 0.59–1.24; P=.41).

CONCLUSIONS

Hospital ward patients on contact precautions were less likely to experience noninfectious adverse events during their hospital stay than patients not on contact precautions.

Infect. Control Hosp. Epidemiol. 2015;36(11):1268–1274

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 11 , November 2015 , pp. 1268 - 1274
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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