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Effects of Contact Precautions on Patient Perception of Care and Satisfaction: A Prospective Cohort Study

Published online by Cambridge University Press:  02 January 2015

Preeti Mehrotra ,
Lindsay Croft ,
Hannah R. Day ,
Eli N. Perencevich ,
Lisa Pineles ,
Anthony D. Harris ,
Saul N. Weingart  and
Daniel J. Morgan
Preeti Mehrotra*
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland
Lindsay Croft
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland
Hannah R. Day
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland
Eli N. Perencevich
Affiliation:
University of Iowa, Carver College of Medicine, Iowa City, Iowa Iowa City VA, Iowa City, Iowa
Lisa Pineles
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland
Anthony D. Harris
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland VA Maryland Health Care System, Baltimore, Maryland
Saul N. Weingart
Affiliation:
Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
Daniel J. Morgan
Affiliation:
University of Maryland School of Medicine, Baltimore, Maryland VA Maryland Health Care System, Baltimore, Maryland
*
Division of Infectious Diseases, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115 (preeti.mehrotra@childrens.harvard.edu)
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Abstract

Objective.

Contact precautions decrease healthcare worker-patient contact and may impact patient satisfaction. To determine the association between contact precautions and patient satisfaction, we used a standardized interview for perceived issues with care.

Design.

Prospective cohort study of inpatients, evaluated at admission and on hospital days 3, 7, and 14 (until discharged). At each point, patients underwent a standardized interview to identify perceived problems with care. After discharge, the standardized interview and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey were administered by telephone. Responses were recorded, transcribed, and coded by 2 physician reviewers.

Participants.

A total of 528 medical or surgical patients not admitted to the intensive care unit.

Results.

A total of 528 patients were included in the primary analysis, of whom 104 (20%) perceived some issue with their care. On multivariable logistic regression, contact precautions were independently associated with a greater number of perceived concerns with care (odds ratio, 2.05 [95% confidence interval, 1.31–3.21]; P<.01), including poor coordination of care (P = .02) and a lack of respect for patient needs and preferences (P = .001). Eighty-eight patients were included in the secondary analysis of HCAHPS. Patients under contact precautions did not have different HCAHPS scores than those not under contact precautions (odds ratio, 1.79 [95% confidence interval, 0.64–5.00]; P = .27).

Conclusions.

Patients under contact precautions were more likely to perceive problems with their care, especially poor coordination of care and a lack of respect for patient preferences.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 10 , October 2013 , pp. 1087 - 1093
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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