Perception of patients and healthcare workers (HCWS) of contact precautions (CP) for multidrug resistant organisms (MDRO)

Background: Contact precautions (CP) for multi-drug resistant organisms (MDRO) have and continue to be a controversial topic in the health-care setting. To control the spread of such organisms within hospitals, interventions involving patient isolation or patient quarantine are utilized. The aim of this study was to evaluate the quality of care for patients under CP isolation as well as healthcare worker perception of modified CP control to ultimately decrease the risks that are encountered from CP and to provide a more effective CP policy that serves patients and healthcare workers better. Methods: A mixed method study within an academic University-affiliated medical system was conducted. Patient care perception and healthcare worker perception were evaluated qualitatively via surveys for eight weeks (June2015-August 2015) with all ICUs assigned to the same strategy. Data was collected using anonymous, self-administered surveys. Four different surveys were distributed between the two groups: 100 patients under CP as well as 100 non-CP patients. A total of 100 health care workers were divided into two sub-categories based on expertise: physicians and nurses and then individuals who specialize in infection control. Results: A total of 200 patients and 100 healthcare workers were interviewed for this study. Using qualitative contact analyses, the interview transcripts showed no significant difference in the quality of care for patients under CP compared to non-CP patients. The average rate for healthcare worker compliance with PPE was 40-70%. Healthcare worker perception of modified CP protocol was evaluated and showed that PPE does not inhibit or limit the quality of care they provide to patients under CP. If contact isolation were to be removed, majority would feel comfortable caring for patients with only the utilization of hand hygiene (HH). Conclusion: Patient care and satisfaction for those under CP was not limited compared to that of non-CP patients. Proposed changes in CP protocol coupled with the comprehensive data collection detected no significant changes in MRDO acquisition and infection. This is important to public health because modifying CP protocol could facilitate and make the work of health care workers more efficient. Further research needs to be done to determine the cost effectiveness as well as waste management (gloves/gowns) of CP to determine its overall usefulness that may inhibit or enhance these findings. (Sponsored by Infection Control Department and Quality Departments UPMC Hospital System