543. Utilization of Isolation Precautions in a Canadian Tertiary Care Centre
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: Increasing application of syndromic surveillance and screening for antibiotic resistant organisms may affect use of isolation precautions in hospitals. The objective of this study was to describe utilization of isolation precautions at a Canadian hospital.
Methods: Use of isolation precautions was recorded for all acute care inpatients at Sunnybrook Health Sciences Centre, a 1100 bed tertiary care teaching hospital in Toronto, ON from Jan 1 to Mar 31 2009. Data collected included: medical service, isolation duration, type, and indication for isolation precautions. Measures calculated included: total and mean number of isolation days, and rates per acute care admissions and inpatient days. All values were compared by medical service, time from admission to initiation, and type of isolation precautions.
Results: During the study period 514 patients were managed in isolation precautions for a total of 5084 isolation days (13% of total inpatient days). Contact precautions accounted for the largest proportion of isolation days (4324 days, 85%), followed by droplet (548 days, 11%) and airborne precautions (170 days, 3%). Infection or colonization with MRSA was the most frequent indication for contact precautions accounting for 1880 isolation days (43%) while 323 isolation days (7%) were due to Clostridium difficile. Isolation days were most frequent in the ICU (171.6 per 1000 ICU days), followed by the medical (145.1 per 1000 medical days) and surgical services (93.5 per 1000 surgical days). The mean duration of isolation precautions was 16 days (range 1-953 days) and was greatest for patients in contact precautions (20 days) as compared to airborne (9 days) or droplet precautions (4 days). 69% of isolation precautions were initiated ≤ 48 hours of admission and the mean duration was twice as long when initiated >48 hrs as compared to ≤ 48 hours after admission (24 vs.12 days;P=0.048).
Conclusion: Isolation precautions are frequently implemented for hospitalized patients, and are associated with a significant use of hospital resources. The utilization of isolation precautions in a hospital needs to be taken into account when considering patient flow, workload and patient safety.
Neera Kumar, _1, Andrew E. Simor, MD, FRCPC1, Victoria Williams, BSc, BASc, MPH, CIC1 and  V. R. Williams, None..
N. R. Kumar, None..
A. E. Simor, None., (1)Sunnybrook Health Sciences Centre, Toronto, ON, Canada