Contact precautions for multidrug-resistant organisms: Current recommendations and actual practice

Am J Infect Control. 2010 Mar;38(2):105-11. doi: 10.1016/j.ajic.2009.08.008. Epub 2009 Nov 12.

Abstract

Background: Contact precautions are recommended for interactions with patients colonized/infected with multidrug-resistant organisms; however, actual rates of implementation of contact precautions are unknown.

Methods: Observers recorded the availability of supplies and staff/visitor adherence to contact precautions at rooms of patients indicated for contact precautions. Data were collected at 3 sites in a New York City hospital network.

Results: Contact precautions signs were present for 85.4% of indicated patients. The largest proportions were indicated for isolation for vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus cultures. Isolation carts were available outside 93.7% to 96.7% of rooms displaying signs, and personal protective equipment was available at rates of 49.4% to 72.1% for gloves (all sizes: small, medium, and large) and 91.7% to 95.2% for gowns. Overall adherence rates on room entry and exit, respectively, were 19.4% and 48.4% for hand hygiene, 67.5% and 63.5% for gloves, and 67.9% and 77.1% for gowns. Adherence was significantly better in intensive care units (P < .05) and by patient care staff (P < .05), and patient care staff compliance with one contact precautions behavior was predictive of adherence to additional behaviors (P < .001).

Conclusions: Our findings support the recommendation that methods to monitor contact precautions and identify and correct nonadherent practices should be a standard component of infection prevention and control programs.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Bacteria / drug effects*
  • Bacterial Infections / microbiology*
  • Bacterial Infections / prevention & control
  • Bacterial Infections / transmission*
  • Drug Resistance, Multiple, Bacterial*
  • Guideline Adherence / statistics & numerical data
  • Guidelines as Topic
  • Health Services Research
  • Humans
  • Infection Control / methods*
  • New York City

Substances

  • Anti-Bacterial Agents