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[Compliance with contact isolation precautions of multidrug-resistant microorganisms in a tertiary hospital]
A González-Estrada1, M Fernández-Prada2, C Martínez Ortega2
1Área de Medicina Preventiva y Salud Pública, Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Asturias, España.
Introduction:
Preventive isolation of patients with multidrug-resistant microorganisms is considered an effective measure to prevent outbreaks in hospitals. The objective of this study is to assess compliance by healthcare workers and family of contact isolation precautions in colonised/infected patients with multidrug-resistant microorganisms.
Methods:
An observational study was conducted from October 2014 to March 2015. A checklist with a structure was designed (equipment trolley), including knowledge of the situation and compliance by the patients, families, and healthcare workers. Univariate and bivariate analyses were performed. Non-parametric tests Mann-Whitney and Kruskal-Wallis were used.
Results:
Out of the 467 observations made, the equipment trolley was correctly situated in 97% (453) of cases, the sphygmomanometer in 90% (421), the stethoscope 43.9% (205), and thermometer 16.5% (77). A dustbin and the alcoholic solution were observed in over 98.7% (461) of cases. The antiseptic soap for patient hygiene was observed to be correctly placed in 348 (74%) of occasions. The situation was known by 84.9% (305) of patients and 91.4% (234) of families. As regards compliance by professionals with the placement/removal of disposable gowns and gloves was about 50% for entering the room (49.5%, 56 gown and 53.09%, 60 gloves), and 40% (28) for leaving the room by professionals. Hand hygiene compliance was 26.5% (30) for entering and 35.2% (25) when leaving.
Conclusions:
There is significant room for improvement in the compliance with isolation precautions. Non-compliance to isolation procedures is not due to a deficit of materials, but to individual behaviours. It is important to implement and evaluate programs based on psychosocial intervention models that can change attitudes and behaviours related to contact isolation precautions for multidrug-resistant microorganisms.
Insights
Compliance with hospital isolation precautions for multidrug-resistant microorganisms is suboptimal. Individual behaviors, not material shortages, drive non-compliance, necessitating psychosocial interventions to improve patient safety.
Area of Science:
- Infection Control
- Public Health
- Healthcare Management
Background:
- Preventive isolation is crucial for controlling hospital outbreaks of multidrug-resistant microorganisms (MDROs).
- Assessing adherence to contact isolation precautions is vital for effective infection prevention strategies.
Purpose of the Study:
- To evaluate healthcare worker and family compliance with contact isolation precautions for patients colonized or infected with MDROs.
- To identify factors influencing adherence to isolation protocols in a hospital setting.
Main Methods:
- An observational study conducted over six months (October 2014 - March 2015).
- Utilized a structured checklist to assess equipment placement, knowledge of isolation status, and compliance with gown/glove use and hand hygiene.
- Employed univariate and bivariate analyses, including non-parametric Mann-Whitney and Kruskal-Wallis tests.
Main Results:
- High compliance with equipment trolley (97%) and dustbin/antiseptic solution (98.7%) placement.
- Lower compliance observed for stethoscope (43.9%) and thermometer (16.5%) placement.
- Healthcare worker compliance with gown/glove use upon entering rooms was around 50%, decreasing to 40% upon leaving.
- Hand hygiene compliance was notably low, at 26.5% upon entering and 35.2% upon leaving rooms.
Conclusions:
- Significant improvements are needed in adherence to isolation precautions.
- Non-compliance stems from individual behaviors rather than material availability.
- Psychosocial intervention programs are recommended to modify attitudes and behaviors for better adherence to contact isolation precautions.
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