Non-contact patient shares room with contact patient...is this typical?

ChocoholicRN · Mar 9, 2008

I'm not sure how much I should get involved in this, because his father is a very private person and I doubt he would want anyone making a huge deal and going to the manager. And I know he wouldn't want to switch rooms because he has a great view (I know what you're all thinking) and he expects to be discharged soon, before his roommate. I wouldn't go to the manager without his knowing and making sure he's okay with it. But even if he ends up staying in this room, I can't sleep well knowing the hospital will continue pairing patients up like this and I didn't do anything about it. Also, how did this get past JCAHO?

core0 · Mar 9, 2008

I'm not sure how much I should get involved in this, because his father is a very private person and I doubt he would want anyone making a huge deal and going to the manager. And I know he wouldn't want to switch rooms because he has a great view (I know what you're all thinking) and he expects to be discharged soon, before his roommate. I wouldn't go to the manager without his knowing and making sure he's okay with it. But even if he ends up staying in this room, I can't sleep well knowing the hospital will continue pairing patients up like this and I didn't do anything about it. Also, how did this get past JCAHO?

Because they probably have a policy not to do this but don't follow it. JCAHO is mostly about documentation not what really goes on. The most telling issue is that I could walk into any hospital in the nation and tell if there is an ongoing JCAHO inspection. How? Its the only time of the year that the halls are free of gurneys, carts, supplies and other miscellaneous junk.

Here is the CDC opinion.

http://www.cdc.gov/ncidod/dhqp/gl_isolation_contact.html

"A single patient room is preferred for patients who require Contact Precautions. When a single-patient room is not available, consultation with infection control personnel is recommended to assess the various risks associated with other patient placement options (e.g., cohorting, keeping the patient with an existing roommate). In multi-patient rooms, >3 feet spatial separation between beds is advised to reduce the opportunities for inadvertent sharing of items between the infected/colonized patient and other patients. Healthcare personnel caring for patients on Contact Precautions should wear a gown and gloves for all interactions that may involve contact with the patient or potentially contaminated areas in the patient’s environment. Donning PPE before room entry and discarding before exiting the patient room is done to contain pathogens, especially those that have been implicated in transmission through environmental contamination (e.g., VRE, C. difficile, noroviruses and other intestinal tract pathogens; RSV)."

So basically the situation described by the OP should not be happening unless the patient developed C-dif after he was already the patients roomate. Its really the reason that pretty much any new hospital are going to single rooms.

David Carpenter, PA-C

ChocoholicRN · Mar 9, 2008

This patient has been in the hospital for over 250 days because he is refusing the surgery he needs, so the hospital is basically going to "evict" him in 2 weeks if nothing changes. Who knows when he contracted C. Diff, but it was definately before he was moved the the room with my bf's father. There was no stethescope assigned just for that patient, and the tech who checked his vital signs not only wore the same pair of gloves for both patients (as mentioned in the original post), but she did not wear a gown either. There is no isolation cart outside the room, but I saw one of the nurses wearing a gown when she cleaned the pt so I don't know where the gowns are kept. Also, the pts wife does not wear a gown when she visits. Do you think I should talk to someone without first making my bf's father aware of what I'm doing? I don't go often to see him, and when I do its in the evening generally when the nurse manager is long gone. And I would feel odd going all the way downtown (I'm uptown) just to speak with a nurse manager when it's not even my family member. Any recommendations?

kimmie518 · Mar 9, 2008

In the hospital I work in, they do cohort contact and noncontact patients as long as they are not airborne (they cohort droplet also). But now with Medicare not reimbursing for nosocomial infections, that will probably change. They are also JHACO accredited, and are well aware of those practices.

Not to defend hospitals that practice this, nor do I don't really want to get into semantics, but the quote from the CDC is their recommendation. As you can see, it uses words like "recommend", "preferred", "advised", "should" and "may". Those are not definite words which can lead to different interpretations to what is appropriate. So it is advised, but doesn't mean it has to be followed (although common sense tells you so).

dakota26 · Mar 11, 2008

We only put the same id together. We would not mix a resp mrsa with a mrsa in the wound. It is a big no no to put a rule out with a positive dirty pt I would bring all concerns to the administration. That is just plain gross not to change gloves.Gross!!

RNsRWe, ASN, RN · Mar 11, 2008

Good morning everyone! So last night I went to visit my boyfriend's father who is in a well known NY city hospital, and I noticed that his roommate is on contact isolation (I believe its C.Diff, but of course they can't tell me). He is on an infectious disease floor, if that makes any difference, and his nurse told me that unless the pt is resp/droplet isolation they can share a room with a non-contact pt. I also noticed that the tech who checked their vital signs wore the same pair of gloves for both pts!! All she did was wipe down the machine (we do that too). Now I have worked in 2 different hospitals and had clinicals in several others, and I have never seen a contact pt share a room with someone unless it was another contact pt. Just recently at my current job, we even had someone who we found out was positive for C.Diff, and as soon as we found out she was switched to a private isolation room. Has anyone else heard of a contact pt sharing a room with a non-contact pt? I just don't want my boyfriends father to get any more sick, he's been in the hospital too long as it is. Thanks for any input! Enjoy your weekend!!

"isolation" requires just that: isolating one patient from the rest of the patient population, and that means a room WITHOUT a roommate! I'd love someone to explain to me how someone can be on CONTACT isolation with a non-infected patient a few feet away?? Does that mean that NOTHING is EVER on his bedside tray that ends up on the other guy's?? Does that mean that NOTHING EVER touches one person and then the other?? OH, please.

I haven't even read past this one post, and it's making my skin cringe. Forget the fact that the tech used the same pair of gloves on both patients--WHY did she bother to WEAR gloves??--the fact remains that quite obviously her clothes were likely in contact with some part of the infected guy's bed linens before brushing against your friend's father's. Contact precautions would have you wear a gown to keep your clothes from touching anything that the infected person would touch.

Man, I'm not even an infection-control queen, and this bugs me! I can only imagine what the ID docs that patrol our halls would say about this. They flip out if we even WALK INTO an isolation room to peer at the patient without touching anything, no kidding. And we're no fancy hospital