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Effects of Contact Precautions on Patient Perception of Care and Satisfaction: A Prospective Cohort Study

Published online by Cambridge University Press:  02 January 2015

Preeti Mehrotra ,
Lindsay Croft ,
Hannah R. Day ,
Eli N. Perencevich ,
Lisa Pineles ,
Anthony D. Harris ,
Saul N. Weingart  and
Daniel J. Morgan
Preeti Mehrotra*
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland
Lindsay Croft
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland
Hannah R. Day
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland
Eli N. Perencevich
Affiliation:
University of Iowa, Carver College of Medicine, Iowa City, Iowa Iowa City VA, Iowa City, Iowa
Lisa Pineles
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland
Anthony D. Harris
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland VA Maryland Health Care System, Baltimore, Maryland
Saul N. Weingart
Affiliation:
Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
Daniel J. Morgan
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland VA Maryland Health Care System, Baltimore, Maryland
*
Division of Infectious Diseases, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115 ([email protected])
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Abstract

Objective.

Contact precautions decrease healthcare worker-patient contact and may impact patient satisfaction. To determine the association between contact precautions and patient satisfaction, we used a standardized interview for perceived issues with care.

Design.

Prospective cohort study of inpatients, evaluated at admission and on hospital days 3, 7, and 14 (until discharged). At each point, patients underwent a standardized interview to identify perceived problems with care. After discharge, the standardized interview and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey were administered by telephone. Responses were recorded, transcribed, and coded by 2 physician reviewers.

Participants.

A total of 528 medical or surgical patients not admitted to the intensive care unit.

Results.

A total of 528 patients were included in the primary analysis, of whom 104 (20%) perceived some issue with their care. On multivariable logistic regression, contact precautions were independently associated with a greater number of perceived concerns with care (odds ratio, 2.05 [95% confidence interval, 1.31–3.21]; P<.01), including poor coordination of care (P = .02) and a lack of respect for patient needs and preferences (P = .001). Eighty-eight patients were included in the secondary analysis of HCAHPS. Patients under contact precautions did not have different HCAHPS scores than those not under contact precautions (odds ratio, 1.79 [95% confidence interval, 0.64–5.00]; P = .27).

Conclusions.

Patients under contact precautions were more likely to perceive problems with their care, especially poor coordination of care and a lack of respect for patient preferences.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 10 , October 2013 , pp. 1087 - 1093
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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References

1.Klevens, RM, Edwards, JR, Richards, CL Jret al.Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep 2007;122:160–166.CrossRefGoogle ScholarPubMed
2.Siegel, JD, Rhinehart, E, Jackson, M, Chiarello, L; Health Care Infection Control Practices Advisory Committee. 2007 guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control 2007;35(suppl 2):S65–S164, doi: 10.1016/j.ajic.2007.10.007.Google Scholar
3.Morgan, DJ, Diekema, DJ, Sepkowitz, K, Perencevich, EN. Adverse outcomes associated with contact precautions: a review of the literature. Am J Infect Control 2009;37:85–93, doi: 10.1016/j.ajic.2008.04.257.CrossRefGoogle ScholarPubMed
4.Evans, HL, Shaffer, MM, Hughes, MG, et al.Contact isolation in surgical patients: a barrier to care? Surgery 2003;134:180–188, doi: 10.1067/msy.2003.222.Google Scholar
5.Stelfox, HT, Bates, DW, Redelmeier, DA. Safety of patients isolated for infection control. JAMA 2003;290:1899–1905, doi: 10.1001/jama.290.14.1899.Google Scholar
6.Day, HR, Perencevich, EN, Harris, AD, et al.Association between contact precautions and delirium at a tertiary care center. Infect Control Hosp Epidemiol 2012;33:34–39, doi: 10.1086/663340.Google Scholar
7.Morgan, DJ, Pineles, LL, Shardell, M, et al.The effect of contact precautions on healthcare worker activity in acute care hospitals. Infect Control Hosp Epidemiol 2013;34:69–73.Google Scholar
8.Gasink, LB, Singer, K, Fishman, NO, et al.Contact isolation for infection control in hospitalized patients: is patient satisfaction affected? Infect Control Hosp Epidemiol 2008;29:275–278, doi:10.1086/527508.Google Scholar
9.Vinski, J, Bertin, M, Sun, Z, et al.Impact of isolation on hospital consumer assessment of healthcare providers and systems scores: is isolation isolating? Infect Control Hosp Epidemiol 2012;33:513–516, doi: 10.1086/665314.Google Scholar
10.Day, HR, Perencevich, EN, Harris, AH, Gruber-Baldini, AL, Himelhoch, SS, Brown, CH, Morgan, DJ. Depression, anxiety and moods of hospitalized patients on contact precautions. Infect Control Hosp Epidemiol 2013:34:251–258.Google Scholar
11.Weingart, SN, Pagovich, O, Sands, DZ, et al.What can hospitalized patients tell us about adverse events? learning from patient-reported incidents. J Gen Intern Med 2005;20:830–836, doi:10.1111/j.1525-1497.2005.0180.x.Google Scholar
12.Zhu, J, Stuver, SO, Epstein, AM, Schneider, EC, Weissman, JS, Weingart, SN. Can we rely on patients' reports of adverse events? Med Care 2011;49: 948–955, doi: 10.1097/MLR.0b013e31822047a8; 10.1097/MLR.0b013e31822047a8.CrossRefGoogle ScholarPubMed
13.Weissman, JS, Schneider, EC, Weingart, SN, et al.Comparing patient-reported hospital adverse events with medical record review: do patients know something that hospitals do not? Ann Intern Med 2008;149:100–108.Google Scholar
14. Centers for Medicare and Medicaid Services. Hospital care quality information from the consumer perspective. http://www.hcahpsonline.org. Accessed May 2011.Google Scholar
15.Deyo, RA, Cherkin, DC, Ciol, MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 1992;45:613–619.CrossRefGoogle ScholarPubMed
16.Day, HR, Perencevich, EN, Harris, AD, et al.Do contact precautions cause depression? a two-year study at a tertiary care medical centre. J Hosp Infect 2011;79:103–107, doi: 10.1016/j.jhin.2011.03.026.Google Scholar
17. Centers for Medicare and Medicaid Services. HCAHPS and hospital VBP. http://www.hcahpsonline.org/HospitalVBP.aspx. Accessed December 20, 2012.Google Scholar
18.Weber, SG, Huang, SS, Oriola, S, et al.Legislative mandates for use of active surveillance cultures to screen for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci: position statement from the joint SHEA and APIC task force. Infect Control Hosp Epidemiol 2007;28:249–260, doi: 10.1086/512261.CrossRefGoogle ScholarPubMed