Not to beat a dead horse, but..........

Here's another paper on adverse events associated with contact precautions. In this study from two French ICUs, 1150 patients were followed for adverse events. Outcomes for patients in contact precautions for MDROs were compared to those who were not in contact precautions. Patients in contact precautions were 1.5-fold more likely to have hypoglycemia and hyperglycemia, 1.9-fold more likely to have anticoagulant prescribing errors, and 2.1-fold more likely to develop VAP due to an MDRO.

When I read the study results I couldn't understand why there could be a causal relationship between contact precautions and anticoagulant prescribing errors. However, the authors later tell us that in these ICUs the patient charts (which are not electronic) are kept in the patient rooms.

I don't think we can blame contact precautions on the higher risk of VAP due to an MDRO. There was no higher risk of VAP due to all pathogens in the contact precautions group. Since patients found to have MDROs would be transferred to contact precautions, it only makes sense that VAP due to MDRO would be more common in patients in contact precautions.

Photo: Massachusetts General Hospital


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