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Accuracy of Healthcare Worker Recall and Medical Record Review for Identifying Infectious Exposures to Hospitalized Patients

Published online by Cambridge University Press:  21 June 2016

M. Aquino ,
J. M. Raboud ,
A. McGeer ,
K. Green ,
R. Chow ,
P. Dimoulas ,
M. Loeb  and
D. Scales
M. Aquino
Affiliation:
Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario
J. M. Raboud
Affiliation:
Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario
A. McGeer*
Affiliation:
Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario
K. Green
Affiliation:
Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario
R. Chow
Affiliation:
Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario
P. Dimoulas
Affiliation:
Department of Microbiology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario
M. Loeb
Affiliation:
Hamilton Health Sciences Center, McMaster University, Hamilton, Ontario
D. Scales
Affiliation:
St. Michael's Hospital, University of Toronto, Toronto, Ontario
*
Mount Sinai Hospital, 600 University Avenue, Room 1460, Toronto, M5G 1X5 Ontario (amcgeer@mtsinai.on.ca)
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Abstract

Objective.

To determine the validity of using healthcare worker (HCW) recall of patient interactions and medical record review for contact tracing in a critical care setting.

Design.

Trained observers recorded the interactions of nurses, respiratory therapists, and service assistants with study patients in a medical-surgical intensive care unit. These observers' records were used as the reference standard to test the criterion validity of using HCW recall data or medical record review data to identify exposure characteristics. We assessed the effects of previous quarantine of the HCW (because of possible exposure) and the availability of patients' medical records for use as memory aids on the accuracy of HCW recall.

Setting.

A 10-bed medical-surgical intensive care unit at Mount Sinai Hospital in Toronto, Ontario.

Patients.

Thirty-six HCWs observed caring for 16 patients, for a total of 55 healthcare worker shifts.

Results.

Recall accuracy was better among HCWs who were provided with patient medical records as memory aids (P<.01). However, HCWs tended to overestimate exposures when they used patient medical records as memory aids. For 6 of 26 procedures or care activities, this tendency to overestimate was statistically significant (P<.05). Most HCWs with true exposures were identified by means of this technique, despite the overestimations. Documentation of the activities of the 4 service assistants could not be found in any of the patients' medical records. Similarly, the interactions between 6 (19%) of 32 other patient–HCW pairs were not recorded in patients' medical records.

Conclusions.

Data collected from follow-up interviews with HCWs in which they are provided with patient medical records as memory aids should be adequate for contact tracing and for determining exposure histories. Neither follow-up interviews nor medical record review alone provide sufficient data for these purposes.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 7 , July 2006 , pp. 722 - 728
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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