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The Effect of Contact Precautions on Frequency of Hospital Adverse Events
Lindsay D Croft1, Michael Liquori2, James Ladd1
11Department of Epidemiology and Public Health,University of Maryland School of Medicine,Baltimore,Maryland.
Objective:
To determine whether use of contact precautions on hospital ward patients is associated with patient adverse events
Design:
Individually matched prospective cohort study
Setting:
The University of Maryland Medical Center, a tertiary care hospital in Baltimore, Maryland
Methods:
A total of 296 medical or surgical inpatients admitted to non-intensive care unit hospital wards were enrolled at admission from January to November 2010. Patients on contact precautions were individually matched by hospital unit after an initial 3-day length of stay to patients not on contact precautions. Adverse events were detected by physician chart review and categorized as noninfectious, preventable and severe noninfectious, and infectious adverse events during the patient's stay using the standardized Institute for Healthcare Improvement's Global Trigger Tool.
Results:
The cohort of 148 patients on contact precautions at admission was matched with a cohort of 148 patients not on contact precautions. Of the total 296 subjects, 104 (35.1%) experienced at least 1 adverse event during their hospital stay. Contact precautions were associated with fewer noninfectious adverse events (rate ratio [RtR], 0.70; 95% confidence interval [CI], 0.51-0.95; P=.02) and although not statistically significant, with fewer severe adverse events (RtR, 0.69; 95% CI, 0.46-1.03; P=.07). Preventable adverse events did not significantly differ between patients on contact precautions and patients not on contact precautions (RtR, 0.85; 95% CI, 0.59-1.24; P=.41).
Conclusions:
Hospital ward patients on contact precautions were less likely to experience noninfectious adverse events during their hospital stay than patients not on contact precautions.
Insights
Contact precautions for hospital patients reduced noninfectious adverse events. This prospective cohort study found fewer adverse events in patients using contact precautions, highlighting their benefit in patient safety.
Area of Science:
- Infection Control and Hospital Epidemiology
- Patient Safety Research
- Clinical Quality Improvement
Background:
- Hospital-acquired adverse events pose a significant risk to patient well-being.
- The efficacy of contact precautions in mitigating these events on general hospital wards requires further investigation.
Purpose of the Study:
- To evaluate the association between the implementation of contact precautions and the occurrence of patient adverse events.
- To determine if contact precautions influence the incidence of infectious and noninfectious adverse events in hospitalized patients.
Main Methods:
- A prospective cohort study was conducted at a tertiary care hospital involving 296 medical or surgical inpatients.
- Patients on contact precautions were individually matched to a control group not on precautions.
- Adverse events were identified via chart review using the Institute for Healthcare Improvement's Global Trigger Tool.
Main Results:
- Contact precautions were associated with a statistically significant reduction in noninfectious adverse events (rate ratio, 0.70; P=.02).
- A trend towards fewer severe adverse events was observed in the contact precaution group, though not statistically significant (P=.07).
- No significant difference in preventable adverse events was found between the groups (P=.41).
Conclusions:
- Hospital ward patients managed with contact precautions experienced fewer noninfectious adverse events.
- Contact precautions may play a role in enhancing patient safety by reducing specific types of adverse events.
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