Impact of contact precautions on falls, pressure ulcers and transmission of MRSA and VRE in hospitalized patients
Name:
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UMass Chan Affiliations
Department of Medicine, Division of Infectious Diseases and ImmunologyDepartment of Quantitative Health Sciences
Document Type
Journal ArticlePublication Date
2014-11-01Keywords
Accidental FallsAged
Cohort Studies
Cross Infection
Gram-Positive Bacterial Infections
Hospitals
Humans
*Infection Control
Male
*Methicillin-Resistant Staphylococcus aureuspurificationMiddle AgedPatient IsolationPressure UlcerRetrospective StudiesStaphylococcal Infections*Vancomycin-Resistant EnterococciBacterial Infections and MycosesInfectious Disease
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BACKGROUND: Hospitals use contact precautions to prevent the spread of meticillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). There is concern that contact precautions may have adverse effects on the safety of isolated patients. In November 2010, the infection control policy at an academic medical centre was modified, and contact precautions were discontinued for patients colonized or infected with MRSA or VRE (MRSA/VRE patients). AIM: To assess the rates of falls and pressure ulcers among MRSA/VRE patients and other adult medical-surgical patients, as well as changes in MRSA and VRE transmission before and after the policy change. METHODS: A single-centre retrospective hospital-wide cohort study was performed from 1st November 2009 to 31st October 2011. FINDINGS: Rates of falls and pressure ulcers were significantly higher among MRSA/VRE patients compared with other adult medical-surgical patients before the policy change (falls: 4.57 vs 2.04 per 1000 patient-days, P < 0.0001; pressure ulcers: 4.87 vs 1.22 per 1000 patient-days, P < 0.0001) and after the policy change (falls: 4.82 vs 2.10 per 1000 patient-days, P < 0.0001; pressure ulcers: 4.17 vs 1.19 per 1000 patient-days, P < 0.0001). No significant differences in the rates of falls and pressure ulcers among MRSA/VRE patients were found after the policy change compared with before the policy change. There was no overall change in MRSA or VRE hospital-acquired transmission. CONCLUSION: MRSA/VRE patients had higher rates of falls and pressure ulcers compared with other adult medical-surgical patients. Rates were not affected by removal of contact precautions, suggesting that other factors contribute to these complications. Further research is required among this population to prevent complications.Source
J Hosp Infect. 2014 Nov;88(3):170-6. doi: 10.1016/j.jhin.2014.09.003. Link to article on publisher's siteDOI
10.1016/j.jhin.2014.09.003Permanent Link to this Item
http://hdl.handle.net/20.500.14038/34992PubMed ID
25441487Related Resources
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