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Are Contact Precautions ethically justifiable in contemporary hospital care

Published on Mar 1, 2019in Nursing Ethics1.957
· DOI :10.1177/0969733017709335
Joanna Harris1
Estimated H-index: 1
(UTAS: University of Tasmania),
Kenneth D. Walsh22
Estimated H-index: 22
(UTAS: University of Tasmania),
Susan Dodds14
Estimated H-index: 14
(UNSW: University of New South Wales)
Abstract
Hospital infection control practices known as Contact Precautions are recommended for the management of people with pathogens such as methicillin-resistant Staphylococcus aureus or vancomycin-resis...
  • References (56)
  • Citations (2)
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References56
Newest
#1Mesut YilmazH-Index: 14
#2Nazif Elaldi (Cumhuriyet University)H-Index: 19
Last. AliMertH-Index: 25
view all 22 authors...
Background Staphylococcus aureus is one of the causes of both community and healthcare-associated bacteremia. The attributable mortality of S. aureus bacteremia (SAB) is still higher and predictors for mortality and clinical outcomes of this condition are need to be clarified. In this prospective observational study, we aimed to examine the predictive factors for mortality in patients with SAB in eight Turkish tertiary care hospitals.
19 CitationsSource
#1Francesco Giuseppe De Rosa (UNITO: University of Turin)H-Index: 23
#2Silvia Corcione (UNITO: University of Turin)H-Index: 14
Last. Giovanni Di Perri (UNITO: University of Turin)H-Index: 34
view all 9 authors...
In this two year retrospective analysis, we evaluated the epidemiology and risk factors for mortality of Staphylococcus aureus bloodstream infection (SaBSI). Methicillin-susceptible S. aureus (MSSA) was isolated in 84 (44.2%) and methicillin-resistant S. aureus (MRSA) in 106 episodes (55.8%). The mortality rate after 21 days was 16.4%. At univariate analysis older age, no removal of central venous catheter (CVC), prosthetic heart valves, severe sepsis, septic shock and high APACHE II score were ...
7 CitationsSource
#1Ravina Kullar (Cubist Pharmaceuticals)H-Index: 17
#2Angela VassalloH-Index: 2
Last. Sorabh Dhar (WSU: Wayne State University)H-Index: 14
view all 6 authors...
16 CitationsSource
#1Mary Wyer (UTAS: University of Tasmania)H-Index: 5
#2Rick Iedema (UTAS: University of Tasmania)H-Index: 39
Last. Gwendolyn L. Gilbert (USYD: University of Sydney)H-Index: 45
view all 10 authors...
Isolation of patients, who are colonised or infected with a multidrug-resistant organism (source-isolation), is a common practice in most acute health-care settings, to prevent transmission to other patients. Efforts to improve the efficacy of source-isolation in hospitals focus on healthcare staff compliance with isolation precautions. In this article we examine patients’ awareness, understandings and observance of source-isolation practices and directives with a view to understanding better th...
2 CitationsSource
#1Lindsay D. Croft (UMB: University of Maryland, Baltimore)H-Index: 9
#2Michael E. Liquori (University of Maryland Medical Center)H-Index: 1
Last. Daniel J. Morgan (UMB: University of Maryland, Baltimore)H-Index: 33
view all 14 authors...
OBJECTIVE To determine whether use of contact precautions on hospital ward patients is associated with patient adverse events DESIGN Individually matched prospective cohort study SETTING The University of Maryland Medical Center, a tertiary care hospital in Baltimore, Maryland METHODS A total of 296 medical or surgical inpatients admitted to non–intensive care unit hospital wards were enrolled at admission from January to November 2010. Patients on contact precautions were individually matched b...
16 CitationsSource
#1Daniel J. Morgan (UMD: University of Maryland, College Park)H-Index: 33
#2Rekha Murthy (Cedars-Sinai Medical Center)H-Index: 8
Last. Gonzalo Bearman (VCU: Virginia Commonwealth University)H-Index: 24
view all 12 authors...
BACKGROUND Whether contact precautions (CP) are required to control the endemic transmission of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) in acute care hospitals is controversial in light of improvements in hand hygiene, MRSA decolonization, environmental cleaning and disinfection, fomite elimination, and chlorhexidine bathing. OBJECTIVE To provide a framework for decision making around use of CP for endemic MRSA and VRE based on a summary of e...
55 CitationsSource
#1C.C. Cohen (Columbia University)H-Index: 1
#2B. Cohen (Columbia University)H-Index: 1
Last. Jingjing Shang (Columbia University)H-Index: 11
view all 3 authors...
Summary Contact precautions are widely recommended to prevent multidrug-resistant organism (MDRO) transmission. However, conflicting data exist regarding their effectiveness. Prior systematic reviews examined contact precautions as part of a larger bundled approach, limiting ability to understand their effectiveness. The aim of this review was to characterize the effectiveness of contact precautions alone against transmission of any MDRO among adult acute care patients. Directed by the Preferred...
25 CitationsSource
#1Thomas Ploug (Centre for Applied Ethics)H-Index: 8
#2Søren Holm (University of Manchester)H-Index: 51
Last. Mickey Gjerris (UCPH: University of Copenhagen)H-Index: 10
view all 3 authors...
Background Multi-resistant bacteria pose an increasing and significant public health risk. As awareness of the severity of the problem grows, it is likely that it will become the target for a range of public health interventions. Some of these can intentionally or unintentionally lead to stigmatization of groups of citizens.
4 CitationsSource
#1Jennifer C. Goldsack (Christiana Care Health System)H-Index: 5
#2Christine DeRitter (Christiana Care Health System)H-Index: 1
Last. Marci Drees (Christiana Care Health System)H-Index: 12
view all 8 authors...
Background There is a large and growing body of evidence that methicillin-resistant Staphylococcus aureus (MRSA) screening programs are cost effective, but such screening represents a significant cost burden for hospitals. This study investigates the clinical, patient experience and cost impacts of performing active surveillance on known methicillin-resistant S aureus positive (MRSA+) patients admitted to 7 medical-surgical units of a large regional hospital, specifically to allow discontinuatio...
17 CitationsSource
Objective. To determine the durability of methicillin-resistant Staphylococcus aureus (MRSA)–free status after patients are removed from contact precautions and the association of specific clearance policy variables with survival.Design. Retrospective cohort study from October 2007 to April 2013.Setting. Veteran Affairs Boston Healthcare System.Participants. Patients with a prior history of MRSA who were removed from contact precautions after deemed cleared of their MRSA status by infection prev...
3 CitationsSource
Cited By2
Newest
#1Teck Chuan Voo (NUS: National University of Singapore)H-Index: 4
#2Zohar LedermanH-Index: 7
Active surveillance cultures and contact precautions is a strategy to control the transmission of methicillin-resistant Staphylococcus aureus (MRSA) within healthcare facilities. Whether to implement this strategy to routinely screen and isolate inpatients with MRSA in non-outbreak (endemic) settings, or to remove it and use standard infection control precautions only is scientifically and ethically controversial, in view of the potential adverse effects of contact precautions on patients. To su...
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#2Thomas VogtH-Index: 52
Last. Sören L. BeckerH-Index: 15
view all 3 authors...
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1 CitationsSource