Data suggest that adherence to contact isolation precautions reduces transmission of multidrug resistant organisms and C. difficile. Compliance with both hand hygiene and contact isolation precautions is suspected to be poor. This study aims to evaluate compliance with contact isolation precautions as documented by direct observation.
We performed sequential observations of 91 healthcare workers to determine their compliance with the five recommended contact isolation precautions: (1) hand hygiene before putting on gowns and gloves, (2) donning of gowns prior to entering the room, (3) donning of gloves prior to entering the room, (4) removal of gowns and gloves upon exiting the room, and (5) hand hygiene after removal of gowns and gloves. Observations were preformed on a general medical/surgical unit and a medical ICU.
A total of 91 serial observations were documented. 51 observations were on the general medical/surgical floor and 40 were preformed in the ICU. 63 (69%) of healthcare workers observed were nurses, 16 (17.6%) were physicians/medical students, and 12 (13.1%) were other healthcare professionals. There were 455 total observations (5 precautions across 91 patients). Of these observations 429 (93.9%) were witnessed and 26 (6.1%) were not witnessed due to challenges with remaining discreet. See Table 1. Ten (10.9%) of healthcare workers complied with all observed precautions. Of these four were physicians and four were nurses. Fourteen (15.4%) of healthcare workers complied with none of the observed precautions. Of these two were physicians and 10 were nurses.
This study illustrates both the challenges of performing direct observation of compliance with contact isolation precautions in a discrete fashion and the suboptimal compliance with recommended isolation precautions, in particular hand hygiene before donning gowns and gloves.
|Observations directly observed (%)||Compliance (%)|
|Hand Hygiene before donning gowns/gloves||79.1||12.5|
|Use of gowns||100||54.9|
|Use of gloves||100||68.1|
|Removal of gowns and gloves||99||57.1|
|Hand Hygiene after removal of gowns/gloves||93.4||70.6|
To cite this abstract:Herzke C, Kaye K, Dhar S, Perl T. Compliance with Recommended Contact Isolation Practices. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97585. Journal of Hospital Medicine. 2012; 7 (suppl 2). https://www.shmabstracts.com/abstract/compliance-with-recommended-contact-isolation-practices/. Accessed November 18, 2019.