This K08 proposal is designed to provide the didactic coursework and research mentoring to enhance Daniel Morgan's efforts to become an independent researcher in hospital epidemiology and quality improvement. He is an infectious diseases physician and Instructor of Epidemiology and Preventive Medicine at the University of Maryland. His long-term goal is to conduct and disseminate research on hospital-acquired infections and interventions that lead to overall quality improvement. In this career award, under the mentoring of outcomes researchers, Drs. Eli Perencevich, Anthony Harris and Lisa Dixon and an expert team of advisors, he proposes completing a Masters in Clinical Research and through his research aims, gaining expertise in measuring quality-of-care, adverse events and psychiatric screening. Contact isolation of patients who are known to be colonized with antibiotic-resistant bacteria is used to prevent transmission of these microorganisms to other patients and limit hospital-acquired infections. It is currently used for approximately 25% of inpatients in acute-care hospitals. These patients are medically complex with multiple illnesses and frequent exposure to healthcare facilities. Patients on contact isolation are less likely to see healthcare workers, have lower quality-of-care process measures, are more likely to become depressed and have low rates of patient satisfaction. Thus, isolated patients are potentially harmed to protect other patients. This project is designed to limit such harm. A methodologically rigorous approach is proposed to quantify the impact and relationship between isolation status of patients and adverse outcomes using a validated clinical data repository of the University of Maryland Medical Center for a historical cohort and a prospective cohort to address adverse events, management of disease, psychiatric screening and patient satisfaction. Using the data from these studies Dr. Morgan will develop and, in a new cohort, validate a novel, easily applied prediction rule to identify those isolated patients at high-risk of developing adverse events. At the end of this award he will be prepared to investigate interventions to decrease adverse events and potentially improve the overall care of the up to 10-15% of hospitalized patients who experience adverse outcomes while on contact isolation.
(See Instructions): Contact isolation is an important tool for preventing hospital-acquired infections. However, the medically complex patient who is placed on contact isolation appears to receive worse care because of isolation. With an increasing number of patients on contact isolation nationwide, it is important to determine the nature of adverse outcomes and methods to prevent such outcomes so that infection control methods can improve overall patient safety.
|Majid, A; McAninch, J; Morgan, D J et al. (2014) Predictors of early treatment discontinuation in a cohort of patients treated with boceprevir-based therapy for hepatitis C infection. J Viral Hepat 21:585-9|
|Drees, Marci; Pineles, Lisa; Harris, Anthony D et al. (2014) Variation in definitions and isolation procedures for multidrug-resistant Gram-negative bacteria: a survey of the Society for Healthcare Epidemiology of America Research Network. Infect Control Hosp Epidemiol 35:362-6|
|Rock, Clare; Thom, Kerri A; Masnick, Max et al. (2014) Frequency of Klebsiella pneumoniae carbapenemase (KPC)-producing and non-KPC-producing Klebsiella species contamination of healthcare workers and the environment. Infect Control Hosp Epidemiol 35:426-9|
|Masnick, Max; Morgan, Daniel J; Wright, Marc-Oliver et al. (2014) Survey of infection prevention informatics use and practitioner satisfaction in US hospitals. Infect Control Hosp Epidemiol 35:891-3|
|Arnold, Ryan; Rock, Clare; Croft, Lindsay et al. (2014) Factors associated with treatment failure in vertebral osteomyelitis requiring spinal instrumentation. Antimicrob Agents Chemother 58:880-4|
|Barnes, Sean L; Morgan, Daniel J; Harris, Anthony D et al. (2014) Preventing the transmission of multidrug-resistant organisms: modeling the relative importance of hand hygiene and environmental cleaning interventions. Infect Control Hosp Epidemiol 35:1156-62|
|Day, Hannah R; Perencevich, Eli N; Harris, Anthony D et al. (2013) Depression, anxiety, and moods of hospitalized patients under contact precautions. Infect Control Hosp Epidemiol 34:251-8|
|Harris, Anthony D; Pineles, Lisa; Belton, Beverly et al. (2013) Universal glove and gown use and acquisition of antibiotic-resistant bacteria in the ICU: a randomized trial. JAMA 310:1571-80|
|Mehrotra, Preeti; Croft, Lindsay; Day, Hannah R et al. (2013) Effects of contact precautions on patient perception of care and satisfaction: a prospective cohort study. Infect Control Hosp Epidemiol 34:1087-93|
|Morgan, Daniel J; Pineles, Lisa; Shardell, Michelle et al. (2013) The effect of contact precautions on healthcare worker activity in acute care hospitals. Infect Control Hosp Epidemiol 34:69-73|
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