Multidrug-Resistant Organisms (MDRO) Infections and Nursing Homes: Columbia Nursing Study Shows Infrequent Isolation Precautions Taken

New research from Columbia University School of Nursing shows that isolation precautions are infrequently used for nursing home residents with multidrug-resistant organisms (MDRO) infections.  

The Centers for Disease Control and Prevention (CDC) and the World Health Organization consider antibiotic resistance to be a serious threat, and past researchers have widely recommended isolation precautions be used to prevent transmission of antibiotic resistant organisms to other residents, visitors and staff. This study shows such recommended isolation precautions to be infrequently used in nursing home settings despite the fact that multidrug-resistant organisms are passed through both direct and indirect contact.

Led by Catherine Cohen, PhD, a postdoctoral research fellow at Columbia Nursing studying with Patricia Stone, PhD, this analysis examined nation-wide data to determine how nursing homes were using isolation precautions when dealing with residents who had an MDRO infection. The study, published February 17, in the Journal of the American Geriatrics Society, looked at nursing homes with Centers for Medicare and Medicaid Services’ certification from October 2010 to December 2013. 

Of the sample of 191,816 assessments of residents with MDRO infection, only 12.8% of these assessments also recorded isolation use. Moreover, 69% of the nursing homes with at least one MDRO infection in the past year did not use isolation precautions for these infections at all.

According to the authors, the study implications lend itself for additional training, policy, and research when it comes to isolation precautions of MDRO positive patients in nursing home settings.

Future research is needed to “inform policies, standardize, and perhaps simplify guidelines and thereby ensure consistent, high-quality care for nursing home residents,” the study concluded. As Centers for Medicare and Medicaid quality inspection citations “were associated with future isolation use, inspections may be a useful tool to align practice with new evidence and policies as they become available.” 


Click here to view the complete study. 

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Elizabeth Holliday