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Contact precautions reduce rate of noninfectious adverse events
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Hospital patients on contact precautions experienced significantly fewer noninfectious adverse events compared with patients not on contact precautions, according to the results of a prospective cohort study.
In addition, there were no significant differences in preventable or severe noninfectious adverse events between the two cohorts in the study.
“Concerns that use of contact precautions may result in adverse events should not limit their implementation,” Daniel J. Morgan, MD, MS, associate professor of epidemiology and public health at the University of Maryland, and colleagues wrote in Infection Control and Hospital Epidemiology.
From January 2010 to November 2010, Morgan and colleagues enrolled 296 medical or surgical patients admitted to nonintensive care unit hospital wards at the University of Maryland Medical Center. Patients on contact precautions (n=148) were individually matched with patients not on contact precautions.
In all, 104 patients (35.1%) experienced at least one adverse event during their hospital admission, the researchers wrote. Of these patients, 49 were on contact precautions.
Daniel J. Morgan
Patients on contact precautions had fewer noninfectious adverse events (RR = 0.7; 95% CI, 0.51-0.95). The researchers also noted a trend toward fewer severe noninfectious adverse events (RR = 0.69, 95% CI, 0.46-1.03), although this was not statistically significant. Rates of preventable adverse events did not differ significantly between the two groups.
These findings differ from previous research. In their prospective cohort study, Stelfox and colleagues found that patients on contact precautions experienced more than twice the rate of adverse events vs. patients not on contact precautions, and the rate of preventable adverse events was seven times as higher. Morgan and colleagues noted that the previous study used a nonstandard definition of adverse events that included abnormal laboratory values without requirement for harm, and inappropriate matching may have confounded the results.
In this study, however, the researchers used a standard definition of adverse events, which made it easier to interpret and compare their findings with other studies.
For now, it is unknown why patients on contact precautions had lower rates of noninfectious adverse events. According to the researchers, it could be related to the fact that patients on contact precautions receive fewer health care personnel visits.
“Less health care personnel contact has been proposed to improve patient care and satisfaction,” Croft and colleagues wrote. “Alternatively, the cognitive process required for considering room entry with contact precautions may have prompted more thoughtful assessment of patient needs, resulting in the observed reduction in noninfectious adverse events.”– by Colleen Owens
Disclosure: Morgan has been a consultant to Welch Allyn. All other authors report no relevant financial disclosures.
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