Contact isolation of new patients reduces adherence to process-of-care quality measures for pneumonia
Hospital patients who are put in contact isolation to prevent the spread of methicillin-resistant Staphylococcus aureus (MRSA) or other drug-resistant healthcare- associated infections (HAIs) are less likely to receive all of the required process-of-care quality steps for pneumonia treatment, according to a new study. Contact isolation, first used for patients in intensive care units (ICUs), is often used for non-ICU patients as part of initiatives to prevent MRSA. The researchers looked at the relationship between contact isolation and adherence to quality-of-care processes for patients admitted for heart attack, congestive heart failure (CHF), pneumonia, or the measure for the Surgical Care Improvement Project (SCIP), which included all patients admitted for cardiac surgery, knee and hip replacement surgery, vascular surgery, colon surgery, and hysterectomy.
After adjustment for patient age, length of hospital stay, mortality risk, and initial admittance to the ICU, patients in contact isolation were one-third as likely to meet the pneumonia measure. In contrast, no effect was seen for heart attack, CHF, and SCIP. The researchers analyzed clinical data on 7,463 patients admitted to a 662-bed urban, acute care teaching hospital from January 2007 through May 2009. The primary outcome of interest was 100 percent adherence to the composite quality-of-care measure for the four admissions groups. This study was funded in part by the Agency for Healthcare Research and Quality (HS18111).
More details are in "The impact of contact isolation on the quality of inpatient hospital care," by Daniel J. Morgan, M.D., Hannah R. Day, Anthony D. Harris, M.D., M.P.H., and others in PLoS ONE 6(7), e22190, 2011.
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