Abstract
Background
Patients who are hospitalized and infected with multidrug-resistant bacteria are usually
placed in contact isolation, which requires hospital personnel to gown and glove before
patient examination. Contact isolation with active culture surveillance appears beneficial
in preventing the spread of drug-resistant infections; however, contact isolation
may impede the ability to examine patients as a result of the additional effort required
to gown and glove. We assessed whether patients who are hospitalized and placed under
contact precautions are examined less often by second- and third-year medical residents
(ie, senior medical residents), and attending physicians during morning rounds.
Method
We conducted a prospective cohort study on the inpatient medical services at 2 university-affiliated
medical centers. We directly observed senior medical residents and attending physicians
during morning rounds, and recorded the contact precaution status of the patient and
whether they were examined by either physician.
Results
Of a total of 139 patients, 31 (22%) were in contact isolation. Senior medical residents
examined 26 of 31 patients (84%) in contact isolation versus 94 of 108 patients (87%)
not in contact isolation (relative risk, 0.96; 95% confidence interval, 0.81–1.14;
P = .58). In comparison, attending physicians examined 11 of 31 patients (35%) in contact
isolation versus 79 of 108 patients (73%) not in contact isolation (relative risk,
0.49; 95% confidence interval, 0.30–0.79; P < .001).
Discussion
Attending physicians are about half as likely to examine patients in contact isolation
compared with patients not in contact isolation.
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References
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Article Info
Footnotes
☆Supported by a career development award from the Health Services Research and Development Program of the Department of Veterans Affairs and a Patient Safety Developmental Center Grant from the Agency for Healthcare Research and Quality (P20-HS11540) (Dr Saint).
☆Presented, in part, at the National Association of Inpatient Physicians 4th Annual National Meeting, Atlanta, GA, March 2001.
Identification
Copyright
© 2003 The Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
