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Contact precautions for HAIs?

Treating and preventing health care-associated infections (HAIs) can be difficult. Reducing patient morbidity and mortality can be difficult in these hard-to-treat infections, such as methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile, and other antibiotic-resistant bacteria, especially when multiple health care workers are caring for these patients.

With this in mind, researchers decided to study what impact contact precautions, a common prevention effort for patients with hard-to-treat infections, would have on patient care, as well as influencing the actions of health care workers.

Contact precautions are infection control measures that require patients to be isolated in their own room or grouped with patients colonized or infected with the same multidrug-resistant organism. Health care workers and visitors must wear gloves, gowns, and other protective equipment while with a patient on contact precautions.

Overall, contact precautions were found to influence the actions of health care workers. Researchers found that contact precautions not only reduced the number of visits by health care workers and outside visitors, but also increased compliance with hand hygiene upon exit of patients’ rooms.

Patients on contact precautions had 36.4% fewer visits from health care workers (2.78 visits/hour for patients on contact precautions and 4.37 visits/hour for those not on precautions). Importantly, health care workers were 15.8% more likely to perform hand hygiene upon exiting isolated patients’ rooms. The frequency of visitors was also impacted by contact precautions, with 23% fewer visitors for patients on precautions.

“Our study shows that contact precautions for patients with drug resistant infections modifies the care they receive,” said Daniel J. Morgan, MD, MS, a lead author of the study. “Fewer visits and increased hand hygiene are important in preventing the spread health care-associated infections, but clinicians and epidemiologists need to consider both the positive and negative aspects of these interventions, including the effect to patients’ mental well-being and perception of care.”