1202. It’s a Confidence Scheme—Transmission-based Precautions in the Ambulatory Setting

Abstract

BackgroundFollowing consistent transmission-based precautions (TBP) beyond the inpatient ward can be challenging. Specifically, ensuring patients are removed when eligible can prevent overuse of TBP and PPE and counter the negative connotations of TBP/Isolation. We sought to enhance providers’ ability to provide TBP for indicated patients only.MethodsWe initiated an iterative process to identify patients eligible for TBP discontinuation based on hospital policy. Staff huddle at the start of each clinic to identify patients needing TBP. An electronic medical record (EMR) report was generated and reviewed by an Infection Preventionist (IP) 3 days in advance of a clinic session to identify and remove eligible patients from TBP. When TBP discontinuation required clinical criteria not available in the EMR, clinic staff were notified and asked to collect the information from families so a decision could be made.ResultsFollowing 6 weeks of review for 5 services, over 30 patients were removed from TBP prior to their visit. IP review entails approximately 20 minutes three times per week. Clinic staff reported greater confidence with enforcing TBP for patients. Specifically, they could trust the list generated the day of clinic, and they understood following TBP was in accordance with policy.ConclusionVerifying the need for TBP in ambulatory patients is not labor intensive. Enhancing the accuracy of lists of patients requiring TBP increases provider confidence in communicating with families and preventing transmission. Increased confidence may empower providers to better utilize TBP appropriately, leading to less waste and dissatisfaction. Disclosures All authors: No reported disclosures.