281. Evaluating Provider Attitudes around Use of Contact Precautions in the Care of Patients with MRSA and VRE
Session: Poster Abstract Session: HAI: MSSA, MRSA, and other Gram-Positives
Thursday, October 27, 2016
Room: Poster Hall

Background: Recent methodologically robust studies suggest that contact precautions (CP) may be of limited utility in preventing transmission of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), and may contribute to patient harm and diminished well-being.  The strength and direction of provider attitudes regarding CP may influence the success in changed institutional CP practices.  As our institution planned to discontinue the use of CP for MRSA and VRE, we sought to ascertain provider attitudes around CP prior to this change to help guide institution-wide education initiatives.

Methods:  A 14 item survey was created using the Research Electronic Data Capture (REDCap) database, and was offered to all inpatient direct care providers, including all provider types. A link to the survey was sent by email with reminders at 5 and 13 days later. All data was collected anonymously and in aggregate form. 

Results: The survey was sent to 5164 providers with 1087 (21%) respondents providing   875 (17%) complete responses.  More than half of each provider type believed that CP help to prevent nosocomial transmission to clinicians, with patient care technicians holding this belief the most strongly (Fig 1).  In each provider type, greater than 70% of respondents believed that CP help to prevent nosocomial environmental transmission.  In contrast, more than half of respondents of each provider type answered that they would not feel comfortable caring for patients colonized with MRSA or VRE without use of gowns and gloves (Fig 2). More than 60% of respondents of all provider types would not feel comfortable caring patients colonized with MRSA or VRE who were not housed in a private room or with another patient with the same organism.  

Conclusion: Our results demonstrate the strong belief among our staff in the efficacy of CP for preventing MRSA and VRE transmission at our institution, which may represent years of training in this practice.  Significant education would be needed on the data for discontinuing CP, including patient and employee safety, and best infection prevention practices for such an intervention to be successful

Figure 1:.  

PCT (Patient Care technician); NP (nurse practitioner); PA (physician assistant); RN (registered nurse); MD (physician)

Figure 2

Preeti Mehrotra, MD1, David S Yassa, MD2, Graham M. Snyder, MD, SM3 and Sharon B Wright, MD, MPH, FIDSA, FSHEA2, (1)Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, (2)Department of Medicine, Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, (3)Beth Israel Deaconess Med. Ctr., Boston, MA

Disclosures:

P. Mehrotra, None

D. S. Yassa, None

G. M. Snyder, None

S. B. Wright, None

Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.