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.

Public Health Relevance

(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.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Clinical Investigator Award (CIA) (K08)
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HSR Health Care Research Training SS (HCRT)
Program Officer
Anderson, Kay
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University of Maryland Baltimore
Public Health & Prev Medicine
Schools of Medicine
United States
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Masnick, Max; Morgan, Daniel J; Sorkin, John D et al. (2017) Can National Healthcare-Associated Infections (HAIs) Data Differentiate Hospitals in the United States? Infect Control Hosp Epidemiol 38:1167-1171
Morgan, Daniel J; Leppin, Aaron L; Smith, Cynthia D et al. (2017) A Practical Framework for Understanding and Reducing Medical Overuse: Conceptualizing Overuse Through the Patient-Clinician Interaction. J Hosp Med 12:346-351
Croft, Lindsay; Ladd, James; Doll, Michelle et al. (2016) Inappropriate Antibiotic Use and Gastric Acid Suppression Preceding Clostridium difficile Infection. Infect Control Hosp Epidemiol 37:494-5
Masnick, Max; Morgan, Daniel J; Sorkin, John D et al. (2016) Lack of Patient Understanding of Hospital-Acquired Infection Data Published on the Centers for Medicare and Medicaid Services Hospital Compare Website. Infect Control Hosp Epidemiol 37:182-7
Morgan, Daniel J; Pineles, Lisa; Shardell, Michelle et al. (2015) Effect of chlorhexidine bathing and other infection control practices on the Benefits of Universal Glove and Gown (BUGG) trial: a subgroup analysis. Infect Control Hosp Epidemiol 36:734-7
Croft, Lindsay D; Liquori, Michael; Ladd, James et al. (2015) The Effect of Contact Precautions on Frequency of Hospital Adverse Events. Infect Control Hosp Epidemiol 36:1268-74
Banach, David B; Bearman, Gonzalo M; Morgan, Daniel J et al. (2015) Infection control precautions for visitors to healthcare facilities. Expert Rev Anti Infect Ther 13:1047-50
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
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
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

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