Safety of patients isolated for infection control
Safety of patients isolated for infection control
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DOI：
10.1001/jama.290.14.1899
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发表时间：
2003-10-08
影响因子：
120.7
通讯作者：
Redelmeier, DA
中科院分区：
文献类型：
--
作者：
Stelfox, HT;Bates, DW;Redelmeier, DA
背景使用患者隔离的医院感染控制政策防止了传染病的医院传播，但可能会无意中导致患者疏忽和错误。目的检查被隔离的感染控制患者所接受的医疗服务的质量。设计、环境和患者我们确定了在北美两家大型教学医院连续隔离的成人耐甲氧西林金黄色葡萄球菌定植或感染：一般队列(1999年1月1日至2000年1月1日期间所有诊断均入院的患者；n=78)；疾病特定队列(1999年1月1日至2002年7月1日期间入院的诊断为充血性心力衰竭的患者；n=72)。为每个孤立的患者选择两个匹配的对照(n=156个普通队列对照和n=144个特定疾病队列对照)。主要结果测量包括过程、结果和满意度的护理质量测量。结果隔离患者和对照患者一般具有相似的基线特征；然而，隔离患者在住院期间发生不良事件的可能性是对照患者的两倍(每1000天31对15个不良事件；P
Context Hospital infection control policies that use patient isolation prevent nosocomial transmission of infectious diseases, but may inadvertently lead to patient neglect and errors.Objective To examine the quality of medical care received by patients isolated for infection control.Design, Setting, and Patients We identified consecutive adults who were isolated for methicillin-resistant Staphylococcus aureus colonization or infection at 2 large North American teaching hospitals: a general cohort (patients admitted with all diagnoses between January 1, 1999, and January 1, 2000; n = 78); and a disease-specific cohort (patients admitted with a diagnosis of congestive heart failure between January 1, 1999, and July 1, 2002; n = 72). Two matched controls were selected for each isolated patient (n = 156 general cohort controls and n = 144 disease-specific cohort controls).Main Outcome Measures Quality-of-care measures encompassing processes, outcomes, and satisfaction. Adjustments for study cohort and patient demographic, hospital, and clinical characteristics were conducted using multivariable regression.Results Isolated and control patients generally had similar baseline characteristics; however, isolated patients were twice as likely as control patients to experience adverse events during their hospitalization (31 vs 15 adverse events per 1000 days; P