Skip to main content
×
×
Home

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

  • Preeti Mehrotra (a1), Lindsay Croft (a1), Hannah R. Day (a1), Eli N. Perencevich (a2) (a3), Lisa Pineles (a1), Anthony D. Harris (a1) (a4), Saul N. Weingart (a5) and Daniel J. Morgan (a1) (a4)...
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.

Copyright
Corresponding author
Division of Infectious Diseases, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115 (preeti.mehrotra@childrens.harvard.edu)
References
Hide All
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;122:160166.
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):S65S164, doi: 10.1016/j.ajic.2007.10.007.
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;37:8593, doi: 10.1016/j.ajic.2008.04.257.
4.Evans, HL, Shaffer, MM, Hughes, MG, et al.Contact isolation in surgical patients: a barrier to care? Surgery 2003;134:180188, doi: 10.1067/msy.2003.222.
5.Stelfox, HT, Bates, DW, Redelmeier, DA. Safety of patients isolated for infection control. JAMA 2003;290:18991905, doi: 10.1001/jama.290.14.1899.
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;33:3439, doi: 10.1086/663340.
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;34:6973.
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;29:275278, doi:10.1086/527508.
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;33:513516, doi: 10.1086/665314.
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 2013:34:251258.
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;20:830836, doi:10.1111/j.1525-1497.2005.0180.x.
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: 948955, doi: 10.1097/MLR.0b013e31822047a8; 10.1097/MLR.0b013e31822047a8.
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;149:100108.
14. Centers for Medicare and Medicaid Services. Hospital care quality information from the consumer perspective. http://www.hcahpsonline.org. Accessed May 2011.
15.Deyo, RA, Cherkin, DC, Ciol, MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 1992;45:613619.
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;79:103107, doi: 10.1016/j.jhin.2011.03.026.
17. Centers for Medicare and Medicaid Services. HCAHPS and hospital VBP. http://www.hcahpsonline.org/HospitalVBP.aspx. Accessed December 20, 2012.
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;28:249260, doi: 10.1086/512261.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 230 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 20th September 2018. This data will be updated every 24 hours.