Using Electronic Documentation for a Contact Investigation in a High-Risk Oncologic Setting
Year: 2015
Type: article
Study design: Observational Study
Abstract: Background. Transmission of tuberculosis from a healthcare worker (HCW) to a patient has been described infrequently. Contact investigations are labor intensive and pose challenges to the infection preventionist. Our goal is to describe a contact investigation after diagnosis of cavitary, smear positive pulmonary Tuberculosis in a HCW with direct patient contact on a high risk oncologic unit. Methods. Contact tracing was performed by querying electronic medical records for all patients admitted to the unit during the infectious period. All assessments, administration of medications, educational moments, and events where the HCW provided care for patients were reviewed. Estimates of daily and cumulative exposures were derived from these records. Electronic employee schedules were used to identify HCWs with shared time on the unit. The concentric circle approach was developed based on this data. Results. There were 137 patients with 5900 interactions with the index case. Administrative and Nursing leadership provided time estimates for each type of interaction. Sixty-three of 137 patients and 146 employees were identified to be at high risk and constituted our “first tier” of the concentric circle for testing. Fifty of the 63 patients and all 146 employees received post exposure testing: * Patient offered prophylaxis but refused. Conclusion. Electronic medical records and employee scheduling systems are useful resources to conduct otherwise labor intensive contact investigations. The widespread implementation of these systems should be routinely utilized for epidemiologic investigations. We estimate that this had a time savings impact of over 1000 person-hours. Despite the high risk features of our index case, a highly vulnerable immunocompromised patient population and extended proximity with co-workers, we did not find any evidence of transmission of active or latent TB among exposed individuals. Disclosures. All authors: No reported disclosures.
Source: Open Forum Infectious Diseases
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,053
OpenAlex ID: W2303936990