Infections caused by resistant pathogens such as multiple-drug resistant tuberculosis (MDR-TB), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant Enterococcus (VRE) result in morbidity and mortality from treatment failures and increased health care costs as newer, more expensive antibiotics are needed to treat infections caused by these organisms.

While more judicious use of antibiotics provides the best means for reducing the burden of such resistant pathogens, studies have demonstrated that communication, use of appropriate barrier precautions, and isolation of identified patients colonized or infected with these pathogens is essential to limiting their spread.

In an effort to facilitate the prevention of spread of these multi-resistant organisms, an isolation precautions flag is now available on the Ulticare system for patients known or suspected to be infected or colonized with drug resistant or other epidemiologically important pathogens that can be transmitted by airborne droplet transmission, or by contact.

The precautions confirm the necessary protective barrier technique (the use of masks, gloves, and/or gowns), as well as the use of a single room with or without negative pressure for each individual patient. The following message will display at the top of the computer screen in the patient's current visit:

Infection Control Precautions

These additional precautions should always be used in combination with Body Substance Precautions (BSPs).

Control of the flag resides with Infection Control Practitioners and with staff physicians of the Infectious Diseases Service. The flag can be removed when transmission of the pathogen is no longer a risk.

Along with staff knowledge of BSPs, the precautions communicated through this flag will serve as a reminder to allow safe, practical patient care to be delivered with minimal delay and disruption to individual patients and staff. On a wider perspective, the utilization and outcomes associated with the use of these precautions can be monitored to assess efficiency and efficacy of care on an ongoing basis.

References:

"Adapting Disease-specific Isolation Guidelines to a Hospital Information System." Jacobson et al. Infection Control 1986 Vol. 7, No.8, p. 411.

"Draft Guideline for Isolation Precautions in Hospitals; Notice" Federal Register Part V. U.S. Department of Health & Human Services: Centers for Disease Control & Prevention. Monday, November 7, 1994.

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