By Rachel Zastrow, RN, BSN, patient safety liaison at Central DuPage Hospital, Winfield, Illinois
Back in March, thousands of infection preventionists and hospital epidemiologists (myself included) descended on Atlanta for the Society of Healthcare Epidemiology of America (SHEA) Decennial Conference. Over 3,500 professionals from 74 countries attended the conference. Despite the wide array of subjects, there were recurring themes that inspired intense emotion.
The topic that elicited the most audience participation involved the recommendation by the Centers for Disease Control and Prevention (CDC) to use N95 masks for worker protection from H1N1 patients. As many readers will know, the recommendation sparked a spike in demand that led to product shortages. The frustration of professionals in the room when the topic arose was palpable. Unfortunately, no consensus came from the conference, and the debate does not seem likely to disappear any time soon. A representative of the CDC defended the controversial recommendation.
AJN readers will remember the furor over mandatory influenza vaccination programs for health care facility employees. Although debate and even lawsuits hit both health care and mainstream news last fall, there was broad consensus among attendees regarding the need to improve vaccination rates in health care workers. Many participants expressed concern over the potential legal and organized labor ramifications of instituting mandatory programs.
Finally, the most interesting and unexpected debate came from a symposium titled “Controversies in Contact Precautions: All Patients Colonized with Multidrug-Resistant Organisms Should be Placed in Contact Precautions.” I chose to attend this session because I was unaware of controversy surrounding isolation. I was intrigued by the idea that something so seemingly fundamental had detractors.
While most nurses are familiar with the arguments for contact isolation, the argument against it is fascinating. The case against routine precautions centered on three problems with the above statement: “all” is too broad, “multidrug-resistant” is too narrow, and (perhaps) contact precautions are the wrong intervention. Both sides had strong arguments, and the audience actually left less supportive of routine contact precautions. Look for an in-depth discussion of both views in a future issue of AJN.