The Impact of Isolation on Healthcare Worker Contact and Compliance With Infection Control Practices in Nursing Homes

Lisa Pineles, Chris Petruccelli, Eli N. Perencevich, Mary Claire Roghmann, Kalpana Gupta, Jose Cadenazuluaga, Gio Baracco, Christopher D. Pfeiffer, Graeme Forrest, Suzanne F. Bradley, Chris Crnich, Heather Reisinger, Daniel J. Morgan

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

OBJECTIVE: To directly observe healthcare workers in a nursing home setting to measure frequency and duration of resident contact and infection prevention behavior as a factor of isolation practice DESIGN: Observational study SETTING AND PARTICIPANTS: Healthcare workers in 8 VA nursing homes in Florida, Maryland, Massachusetts, Michigan, Washington, and Texas METHODS: Over a 15-month period, trained research staff without clinical responsibilities on the units observed nursing home resident room activity for 15–30-minute intervals. Observers recorded time of entry and exit, isolation status, visitor type (staff, visitor, etc), hand hygiene, use of gloves and gowns, and activities performed in the room when visible. RESULTS: A total of 999 hours of observation were conducted across 8 VA nursing homes during which 4,325 visits were observed. Residents in isolation received an average of 4.73 visits per hour of observation compared with 4.21 for nonisolation residents (P<.01), a 12.4% increase in visits for residents in isolation. Residents in isolation received an average of 3.53 resident care activities per hour of observation, compared with 2.46 for residents not in isolation (P<.01). For residents in isolation, compliance was 34% for gowns and 58% for gloves. Healthcare worker hand hygiene compliance was 45% versus 44% (P=.79) on entry and 66% versus 55% (P<.01) on exit for isolation and nonisolation rooms, respectively. CONCLUSIONS: Healthcare workers visited residents in isolation more frequently, likely because they required greater assistance. Compliance with gowns and gloves for isolation was limited in the nursing home setting. Adherence to hand hygiene also was less than optimal, regardless of isolation status of residents. Infect Control Hosp Epidemiol 2018;1–5

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalInfection Control and Hospital Epidemiology
DOIs
StateAccepted/In press - Apr 2 2018
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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