Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025
Contact precautions in a palliative care unit: a retrospective chart review at a canadian tertiary hospital.
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He Henry T, Bunn Shannon, Rance Brittany
Аннотация
OBJECTIVE: To characterize the incidence of contact precautions (CPs) on a palliative care unit (PCU) at a tertiary hospital in Canada.
DESIGN: Descriptive retrospective chart review.
SETTING: Palliative care unit.
PARTICIPANTS: Adults admitted to the PCU who were placed on CPs during admission.
METHODS: A retrospective chart review was conducted on all PCU admissions for 25 months from September 24, 2022, to October 29, 2024. Patient orders, clinical notes, medication records, microbiology results, and transport documentation were reviewed. A descriptive and basic comparative statistical analysis was performed.
RESULTS: CPs were used in 13 of 549 patient encounters (2.37%), with an incidence of 2.02 per 1,000 PCU patient-days. Indications included known MRSA (5/13), suspected CPO (4/13), new MRSA (3/13), and known vancomycin-resistant Enterococcus (1/13). The mean duration of CPs was 15.4 ± 14.1 (range 0.2-47.8) days. Mean hospital and PCU lengths of stay in the CP group were 24.8 ± 14.7 and 14.6 ± 14.8 days, respectively, compared to 23.8 ± 31.3 and 11.7 ± 11.7 days in the non-CP group (P = .816 for hospital stay; P = .491 for PCU stay). No significant differences were observed between groups in age, sex, or length of stay. Antibiotics were used in 9/13 patients, and 5/13 patients remained on CPs until death on the PCU.
CONCLUSIONS: This study is the first known retrospective review of CP use in palliative care. Further research is needed to explore its impact on infection outcomes, mortality, and patient-centered measures.
DESIGN: Descriptive retrospective chart review.
SETTING: Palliative care unit.
PARTICIPANTS: Adults admitted to the PCU who were placed on CPs during admission.
METHODS: A retrospective chart review was conducted on all PCU admissions for 25 months from September 24, 2022, to October 29, 2024. Patient orders, clinical notes, medication records, microbiology results, and transport documentation were reviewed. A descriptive and basic comparative statistical analysis was performed.
RESULTS: CPs were used in 13 of 549 patient encounters (2.37%), with an incidence of 2.02 per 1,000 PCU patient-days. Indications included known MRSA (5/13), suspected CPO (4/13), new MRSA (3/13), and known vancomycin-resistant Enterococcus (1/13). The mean duration of CPs was 15.4 ± 14.1 (range 0.2-47.8) days. Mean hospital and PCU lengths of stay in the CP group were 24.8 ± 14.7 and 14.6 ± 14.8 days, respectively, compared to 23.8 ± 31.3 and 11.7 ± 11.7 days in the non-CP group (P = .816 for hospital stay; P = .491 for PCU stay). No significant differences were observed between groups in age, sex, or length of stay. Antibiotics were used in 9/13 patients, and 5/13 patients remained on CPs until death on the PCU.
CONCLUSIONS: This study is the first known retrospective review of CP use in palliative care. Further research is needed to explore its impact on infection outcomes, mortality, and patient-centered measures.