Contact precautions for multidrug-resistant organisms: Current recommendations and actual practice.
BACKGROUND
Contact precautions are recommended for interactions with patients colonized/infected with multidrug-resistant organisms; however, actual rates of implementation of contact precautions are unknown.


METHODS
Observers recorded the availability of supplies and staff/visitor adherence to contact precautions at rooms of patients indicated for contact precautions. Data were collected at 3 sites in a New York City hospital network.


RESULTS
Contact precautions signs were present for 85.4% of indicated patients. The largest proportions were indicated for isolation for vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus cultures. Isolation carts were available outside 93.7% to 96.7% of rooms displaying signs, and personal protective equipment was available at rates of 49.4% to 72.1% for gloves (all sizes: small, medium, and large) and 91.7% to 95.2% for gowns. Overall adherence rates on room entry and exit, respectively, were 19.4% and 48.4% for hand hygiene, 67.5% and 63.5% for gloves, and 67.9% and 77.1% for gowns. Adherence was significantly better in intensive care units (P < .05) and by patient care staff (P < .05), and patient care staff compliance with one contact precautions behavior was predictive of adherence to additional behaviors (P < .001).


CONCLUSIONS
Our findings support the recommendation that methods to monitor contact precautions and identify and correct nonadherent practices should be a standard component of infection prevention and control programs.
Clock
Sarah A
SA
Center for Interdisciplinary Research to Reduce Antimicrobial Resistance, Columbia University, New York, NY, USA.
Cohen
Bevin
B
Behta
Maryam
M
Ross
Barbara
B
Larson
Elaine L
EL
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects*; D001424:Bacterial Infections / Q000382:microbiology* / Q000517:prevention & control / Q000635:transmission*; D024901:Drug Resistance, Multiple, Bacterial; D019983:Guideline Adherence / Q000706:statistics & numerical data; D017408:Guidelines as Topic; D006302:Health Services Research; D006801:Humans; D017053:Infection Control / Q000379:methods*; D009519:New York City
D000900:Anti-Bacterial Agents