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 Cadena, Gio Baracco, Christopher Pfeiffer, Graeme Forrest, Suzanne F. Bradley, Chris Crnich, Heather Reisinger, Daniel J. Morgan

Research output: Contribution to journalArticle

2 Citations (Scopus)

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 practiceDESIGN 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.

Original languageEnglish (US)
Pages (from-to)683-687
Number of pages5
JournalInfection control and hospital epidemiology
Volume39
Issue number6
DOIs
StatePublished - Jun 1 2018

Fingerprint

Infection Control
Nursing Homes
Hand Hygiene
Delivery of Health Care
Observation
Compliance
Observational Studies
Infection
Research

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Pineles, L., Petruccelli, C., Perencevich, E. N., Roghmann, M. C., Gupta, K., Cadena, J., ... Morgan, D. J. (2018). The Impact of Isolation on Healthcare Worker Contact and Compliance with Infection Control Practices in Nursing Homes. Infection control and hospital epidemiology, 39(6), 683-687. https://doi.org/10.1017/ice.2018.50

The Impact of Isolation on Healthcare Worker Contact and Compliance with Infection Control Practices in Nursing Homes. / Pineles, Lisa; Petruccelli, Chris; Perencevich, Eli N.; Roghmann, Mary Claire; Gupta, Kalpana; Cadena, Jose; Baracco, Gio; Pfeiffer, Christopher; Forrest, Graeme; Bradley, Suzanne F.; Crnich, Chris; Reisinger, Heather; Morgan, Daniel J.

In: Infection control and hospital epidemiology, Vol. 39, No. 6, 01.06.2018, p. 683-687.

Research output: Contribution to journalArticle

Pineles, L, Petruccelli, C, Perencevich, EN, Roghmann, MC, Gupta, K, Cadena, J, Baracco, G, Pfeiffer, C, Forrest, G, Bradley, SF, Crnich, C, Reisinger, H & Morgan, DJ 2018, 'The Impact of Isolation on Healthcare Worker Contact and Compliance with Infection Control Practices in Nursing Homes', Infection control and hospital epidemiology, vol. 39, no. 6, pp. 683-687. https://doi.org/10.1017/ice.2018.50
Pineles, Lisa ; Petruccelli, Chris ; Perencevich, Eli N. ; Roghmann, Mary Claire ; Gupta, Kalpana ; Cadena, Jose ; Baracco, Gio ; Pfeiffer, Christopher ; Forrest, Graeme ; Bradley, Suzanne F. ; Crnich, Chris ; Reisinger, Heather ; Morgan, Daniel J. / The Impact of Isolation on Healthcare Worker Contact and Compliance with Infection Control Practices in Nursing Homes. In: Infection control and hospital epidemiology. 2018 ; Vol. 39, No. 6. pp. 683-687.
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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 practiceDESIGN 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.",
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N2 - 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 practiceDESIGN 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.

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