The Effect of Contact Precautions on Frequency of Hospital Adverse Events.
OBJECTIVE
To determine whether use of contact precautions on hospital ward patients is associated with patient adverse events


METHODS
Individually matched prospective cohort study


METHODS
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.
1Department of Epidemiology and Public Health,University of Maryland School of Medicine,Baltimore,Maryland.
Lindsay D
LD
Croft
2Department of Medicine,University of Maryland Medical Center,Baltimore,Maryland.
Michael
M
Liquori
1Department of Epidemiology and Public Health,University of Maryland School of Medicine,Baltimore,Maryland.
James
J
Ladd
1Department of Epidemiology and Public Health,University of Maryland School of Medicine,Baltimore,Maryland.
Hannah
H
Day
1Department of Epidemiology and Public Health,University of Maryland School of Medicine,Baltimore,Maryland.
Lisa
L
Pineles
2Department of Medicine,University of Maryland Medical Center,Baltimore,Maryland.
Elizabeth
E
Lamos
2Department of Medicine,University of Maryland Medical Center,Baltimore,Maryland.
Ryan
R
Arnold
4Division of Infectious Diseases,Department of Medicine,Boston Children's Hospital,Boston,Massachusetts.
Preeti
P
Mehrotra
1Department of Epidemiology and Public Health,University of Maryland School of Medicine,Baltimore,Maryland.
Jeffrey C
JC
Fink
1Department of Epidemiology and Public Health,University of Maryland School of Medicine,Baltimore,Maryland.
Patricia
P
Langenberg
6Department of Pharmaceutical Health Services,University of Maryland School of Pharmacy,Baltimore,Maryland.
Linda
L
Simoni-Wastila
7Carver College of Medicine,University of Iowa,Iowa City,Iowa.
Eli
E
Perencevich
1Department of Epidemiology and Public Health,University of Maryland School of Medicine,Baltimore,Maryland.
Anthony D
AD
Harris
1Department of Epidemiology and Public Health,University of Maryland School of Medicine,Baltimore,Maryland.
Daniel J
DJ
Morgan
D000368:Aged; D015142:Baltimore; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006757:Hospital Units; D006801:Humans; D017053:Infection Control / Q000592:standards*; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D062606:Tertiary Care Centers