Kamis, 21 Oktober 2010

Are we ready to kill contact precautions?

Pauline Chen, in her New York Times column, Doctor and Patient, takes on contact precautions this week. Her piece, When Isolation Hampers More than Bacteria, is one of the first in the mainstream media to point out the unintended consequences of contact precautions. This has been a recurring theme on our blog. In one of the very first postings on this blog, Dan wrote a piece entitled, Why I hate contact precautions. Just this week I was asked by a concerned medical student to review the case of an elderly man hospitalized for over 3 months and confined to a lonely hospital room because a nasal swab grew MRSA. "Can't we just allow him to sit in the hallway?" asked the student. And we figured out a way to do that. Dan Morgan states in Chen's piece: “There is a misperception that infections are the single worst adverse event that can happen in a hospital.”  Also quoted in the piece is my colleague, Gonzalo Bearman, regarding our studies comparing universal gloving and contact precautions, which found no difference in infection rates when the two strategies were compared. Maybe it's finally time to think about moving beyond contact precautions.

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