Center for Interdisciplinary Research to Reduce Antimicrobial Resistance, Columbia University, New York, NY, USA.
Am J Infect Control. 2010 Mar;38(2):105-11. doi: 10.1016/j.ajic.2009.08.008. Epub 2009 Nov 12.
Contact precautions are recommended for interactions with patients colonized/infected with multidrug-resistant organisms; however, actual rates of implementation of contact precautions are unknown.
Observers recorded the availability of supplies and staff/visitor adherence to contact precautions at rooms of patients indicated for contact precautions. Data were collected at 3 sites in a New York City hospital network.
Contact precautions signs were present for 85.4% of indicated patients. The largest proportions were indicated for isolation for vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus cultures. Isolation carts were available outside 93.7% to 96.7% of rooms displaying signs, and personal protective equipment was available at rates of 49.4% to 72.1% for gloves (all sizes: small, medium, and large) and 91.7% to 95.2% for gowns. Overall adherence rates on room entry and exit, respectively, were 19.4% and 48.4% for hand hygiene, 67.5% and 63.5% for gloves, and 67.9% and 77.1% for gowns. Adherence was significantly better in intensive care units (P < .05) and by patient care staff (P < .05), and patient care staff compliance with one contact precautions behavior was predictive of adherence to additional behaviors (P < .001).
Our findings support the recommendation that methods to monitor contact precautions and identify and correct nonadherent practices should be a standard component of infection prevention and control programs.
接触预防措施被推荐用于与携带/感染多药耐药菌的患者进行接触；然而，接触预防措施的实际实施率尚不清楚。
观察者记录了在接触预防措施指示的患者病房中，供应品和员工/访客遵守接触预防措施的情况。数据在纽约市一家医院网络的 3 个地点收集。
接触预防措施标志存在于 85.4%的指示患者中。最大比例的患者被指示进行万古霉素耐药肠球菌和耐甲氧西林金黄色葡萄球菌培养的隔离。在显示标志的 93.7%至 96.7%的病房外可提供隔离车，手套（所有尺寸：小、中、大）的个人防护设备可用性分别为 49.4%至 72.1%，而长袍的可用性为 91.7%至 95.2%。进出房间时的总体遵守率分别为手卫生的 19.4%和 48.4%、手套的 67.5%和 63.5%以及长袍的 67.9%和 77.1%。在重症监护病房（P<.05）和由患者护理人员（P<.05）遵守情况更好，并且患者护理人员遵守一种接触预防措施行为与遵守其他行为（P<.001）呈正相关。
我们的研究结果支持这样的建议，即监测接触预防措施并识别和纠正不遵守行为的方法应该成为感染预防和控制计划的标准组成部分。
