351. Effect of Contact Precautions on Frequency of Hospital Adverse Events
Session: Poster Abstract Session: MRSA, MSSA, Enterococci
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C

Background: Contact Precautions are commonly used for methicillin-resistant Staphylococcus aureus and other organisms and have been reported to decrease healthcare worker visits and increase the number of medical harms such as pressure ulcers or falls. Our objective was to determine the association between Contact Precautions and patient adverse events, as measured by an electronic Institute for Healthcare Improvement (IHI) trigger tool (“unintended physical injury resulting from or contributed to by medical care”).

Methods: Prospective cohort study of inpatients followed through discharge from January to November 2010 at the University of Maryland Medical Center. Patients were enrolled at admission and frequency matched by hospital unit and length of stay. Three physician reviewers performed patient chart reviews to identify adverse events using an electronic IHI trigger tool. Each chart was reviewed by one to three physicians. Preventability of each adverse event was also recorded. Logistic regression analysis was used for our primary analysis of Contact Precautions and patient adverse events.

Results: Of 296 frequency matched patients, 83 patients (28.0%) had adverse events. Contact Precautions were not associated with more frequent adverse events (OR 1.22, 95% confidence interval (CI) 0.71-2.08, p= 0.48) after adjusting for age greater than 51 years (OR 2.07, 95% CI 1.19-3.59), length of stay greater than 4 days (OR 2.72, 95% CI 1.57-4.70), and Charlson comorbidity score (OR 1.05, 95% CI 0.91-1.20). Among 83 adverse events, 41 (49.4%) were preventable. Preventable adverse events were also no more common among patients on Contact Precautions (OR 1.17, 95% CI 0.60-2.27, p= 0.65).

Conclusion: Patients on Contact Precautions do not appear to be more likely to experience adverse events than patients not on Contact Precautions.

Lindsay Croft, MS, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, Preeti Mehrotra, MD, Internal Medicine, University of Maryland School of Medicine/ Maryland VA Healthcare System, BALTIMORE, MD, Hannah Day, PhD, University of Maryland School of Medicine/ Maryland VA Healthcare System, BALTIMORE, MD, Beth Lamos, MD, University of Maryland School of Medicine, Baltimore, MD, Ryan Arnold, MD, Division of Infectious Diseases, University of Maryland, Baltimore, MD, Eli Perencevich, MD, MS, FIDSA, FSHEA, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, Anthony D. Harris, MD, MPH, Departmetn of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD and Daniel Morgan, MD, MS, Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD

Disclosures:

L. Croft, None

P. Mehrotra, None

H. Day, None

B. Lamos, None

R. Arnold, None

E. Perencevich, None

A. D. Harris, Premier: Consultant, Consulting fee
Cubist: Consultant, Consulting fee
Sanogiene: Consultant, Consulting fee
UpToDate, Online: Consultant, Consulting fee

D. Morgan, Welch Allyn : Consultant, Consulting fee
Sanogiene : Consultant, Consulting fee

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