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Accuracy of Healthcare Worker Recall and Medical Record Review for Identifying Infectious Exposures to Hospitalized Patients

Published online by Cambridge University Press:  07 April 2017

M. Aquino ,
J. M. Raboud ,
A. McGeer ,
K. Green ,
R. Chow ,
P. Dimoulas ,
M. Loeb  and
D. Scales
M. Aquino
Affiliation:
Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario
J. M. Raboud
Affiliation:
Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario
A. McGeer*
Affiliation:
Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario
K. Green
Affiliation:
Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario
R. Chow
Affiliation:
Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario
P. Dimoulas
Affiliation:
Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario
M. Loeb
Affiliation:
Hamilton Health Sciences Center, McMaster University, Hamilton, Ontario
D. Scales
Affiliation:
St. Michael's Hospital, University of Toronto, Toronto, Ontario
*
Mount Sinai Hospital, 600 University Avenue, Room 1460, Toronto, M5G 1X5 Ontario ([email protected])
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Abstract

Objective.

To determine the validity of using healthcare worker (HCW) recall of patient interactions and medical record review for contact tracing in a critical care setting.

Design.

Trained observers recorded the interactions of nurses, respiratory therapists, and service assistants with study patients in a medical-surgical intensive care unit. These observers' records were used as the reference standard to test the criterion validity of using HCW recall data or medical record review data to identify exposure characteristics. We assessed the effects of previous quarantine of the HCW (because of possible exposure) and the availability of patients' medical records for use as memory aids on the accuracy of HCW recall.

Setting.

A 10-bed medical-surgical intensive care unit at Mount Sinai Hospital in Toronto, Ontario.

Patients.

Thirty-six HCWs observed caring for 16 patients, for a total of 55 healthcare worker shifts.

Results.

Recall accuracy was better among HCWs who were provided with patient medical records as memory aids (P<.01). However, HCWs tended to overestimate exposures when they used patient medical records as memory aids. For 6 of 26 procedures or care activities, this tendency to overestimate was statistically significant (P<.05). Most HCWs with true exposures were identified by means of this technique, despite the overestimations. Documentation of the activities of the 4 service assistants could not be found in any of the patients' medical records. Similarly, the interactions between 6 (19%) of 32 other patient–HCW pairs were not recorded in patients' medical records.

Conclusions.

Data collected from follow-up interviews with HCWs in which they are provided with patient medical records as memory aids should be adequate for contact tracing and for determining exposure histories. Neither follow-up interviews nor medical record review alone provide sufficient data for these purposes.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 7 , July 2006 , pp. 722 - 728
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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References

1.Varia, M, Wilson, S, Sarwal, S, et al; Hospital Outbreak Investigation Team. Investigation of a nosocomial outbreak of severe acute respiratory syndrome (SARS) in Toronto, Canada. CMAJ 2003; 169:285–292.Google ScholarPubMed
2.Centers for Disease Control and Prevention. Severe acute respiratory syndrome—Taiwan, 2003. MMWR Morb Mortal Wkly Rep 2003; 52:461–466.Google Scholar
3.Loeb, M, McGeer, A, Henry, B, et al. SARS among critical care nurses, Toronto. Emerg Infect Dis 2004; 10:251–255.CrossRefGoogle ScholarPubMed
4.Scales, DC, Green, K, Chan, AK, et al. Illness in intensive-care staff after brief exposure to severe acute respiratory syndrome. Emerg Infect Dis 2003; 9:1205–1210.CrossRefGoogle ScholarPubMed
5.Lau, J, Fung, KS, Wong, TW, et al. SARS transmission among hospital workers in Hong Kong. Emerg Infect Dis 2004; 10:280–286.Google Scholar
6.Park, B, Peck, A, Kuehnert, M, et al. Lack of SARS transmission among health care workers, United States. Emerg Infect Dis 2004; 10:244–248.Google Scholar
7.Teleman, MD, Baudville, IC, Heng, BH, Zhu, D, Leo, YS. Factors associated with transmission of severe acute respiratory syndrome among healthcare workers in Singapore. Epidemiol Infect 2004; 132:797–803.CrossRefGoogle ScholarPubMed
8.Kenyon, TA, Ridzon, R, Luskin-Hawk, R, et al. A nosocomial outbreak of multidrug-resistant tuberculosis. Ann Intern Med 1997; 127:32–36.CrossRefGoogle ScholarPubMed
9.Zaza, S, Blumberg, HM, Beck-Sague, C, et al. Nosocomial transmission of Mycobacterium tuberculosis: role of health care workers in outbreak propagation. J Infect Dis 1995; 172:1542–1549.Google Scholar
10.Ehrenberg, A, Ehnfors, M. The accuracy of patient records in Swedish nursing homes: congruence of record content and nurses' and patients' descriptions. Scand J Caring Sci 2001; 15:303–310.Google Scholar
11.Aaronson, LS, Burman, ME. Use of health records in research: reliability and validity issues. Res Nurs Health 1994; 17:67–73.Google Scholar
12.Karkkainen, O, Eriksson, K. Evaluation of patient records as part of developing a nursing care classification. J Clin Nurs 2003; 12:198–205.Google Scholar
13.Davis, B, Billings, J, Ryland, R. Evaluation of nursing process documentation. J Adv Nurs 1994; 19:960–968.CrossRefGoogle ScholarPubMed
14.Ehnfors, M, Smedby, B. Nursing care as documented in patient records. Scand J Caring Sci 1993; 7:209–220.CrossRefGoogle ScholarPubMed
15.Seto, WH, Tsang, D, Yung, RW, et al. Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS). Lancet 2003; 361:1519–1520.Google Scholar
16.Lau, J, Yang, X, Leung, PC, et al. SARS in three categories of hospital workers, Hong Kong. Emerg Infect Dis 2004; 10:1399–1404.Google Scholar
17.Maunder, R, Hunter, J, Vincent, L, et al. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ 2003; 168:1245–1251.Google Scholar
18.Hawryluck, L, Gold, WL, Robinson, S, Pogorski, S, Galea, S, Styra, R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis 2004; 10:1206–1212.Google Scholar
19.Eveillard, M, Martin, Y, Hidri, N, Boussougant, Y, Joly-Guillou, ML. Carriage of methicillin-resistant Staphylococcus aureus among hospital employees: prevalence, duration, and transmission to households. Infect Control Hosp Epidemiol 2004; 25:114–120.CrossRefGoogle ScholarPubMed
20.Moro, ML, Errante, I, Infuso, A, et al. Effectiveness of infection control measures in controlling a nosocomial outbreak of multidrug-resistant tuberculosis among HIV patients in Italy. Int J Tuberc Lung Dis 2000; 4:61–68.Google Scholar