{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:21:50Z","timestamp":1788348110001,"version":"build-2803163510"},"reference-count":40,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi220082-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Although contact isolation has been widely recommended for multidrug-resistant organisms, contact isolation has raised some concerns that it may bring unintended patient harms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi220082-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To compare adverse events between a contact isolation group with vancomycin-resistant\n                      <jats:italic toggle=\"yes\">Enterococcus<\/jats:italic>\n                      (VRE) and a matched comparison group using a relatively large data set from full electronic medical records (EMR) and propensity score\u2013matching methods.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi220082-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This retrospective, matched cohort study was conducted at Seoul National University Bundang Hospital (SNUBH) in Korea, a tertiary, university-affiliated hospital that has 1337 inpatient beds. Participants included a total of 98\u202f529 hospitalized adult patients (aged \u226518 years) during 2015 to 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi220082-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>Contact isolation in a single or shared double room.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi220082-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>As adverse contact isolation\u2013related outcomes, falls and pressure ulcers were included. All relevant EMR data were extracted from the SNUBH clinical data warehouse. Risk factors for adverse events were included in the propensity score model based on literature reviews, such as Braden scale score and Hendrich II fall risk score. A fine stratification and weighting (FSW) and a 1:10 nearest neighbor (NN) propensity score matching as a sensitivity analysis were adopted to compare adverse events between the 2 groups for the observation period from the study entry date and the exit date. Time-to-event analyses with a Cox proportional hazard model were conducted in December 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi220082-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For comparison of outcomes in wards, 177 patients (mean [SD] age, 67.38 [14.12] years; 98 [55.4%] female) with VRE and 93\u202f022 patients (mean [SD] age, 56.44 [16.88] years; 49\u202f462 [53.2%] female) without VRE were included and no difference was found in basic characteristics from the FSW (VRE contact isolation [n\u2009=\u2009172] vs comparison [n\u2009=\u200969\u202f434]) as well as from the 1:10 NN (VRE contact isolation [n\u2009=\u2009168] vs comparison [n\u2009=\u20091650]). Among 177 patients with VRE contact isolation, 8 pressure ulcers and 3 falls occurred during their hospital stays; incidence rates of adverse events were 2.5 and 0.9 per 1000 patient-days, respectively (pressure ulcer incidence rate from the FSW: 2.53 per 1000 patient-days [95% CI, 1.09-4.99 per 1000 patient-days]; pressure ulcer incidence rate from the 1:10 NN: 2.54 per 1000 patient-days [95% CI, 1.10-5.01 per 1000 patient-days]; fall incidence rate from the FSW: 0.87 per 1000 patient-days [95% CI, 0.18-2.54 per 1000 patient-days]; fall incidence rate from the 1:10 NN: 0.87 per 1000 patient-days [95% CI, 0.18-2.55 per 1000 patient-days]). The hazard ratios for adverse events showed no statistically significant differences for both groups: 1.42 (95% CI, 0.67-2.99) for pressure ulcer and 0.66 (95% CI, 0.20-2.13) for fall from the FSW.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi220082-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this cohort study, no association was found between the likelihood of adverse events and contact isolation using propensity score\u2013matching methods and closely related covariates for adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.1865","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T11:03:41Z","timestamp":1646910221000},"page":"e221865","source":"Crossref","is-referenced-by-count":6,"title":["Evaluation of Patients\u2019 Adverse Events During Contact Isolation for Vancomycin-Resistant\n                    <i>Enterococci<\/i>\n                    Using a Matched Cohort Study With Propensity Score"],"prefix":"10.1001","volume":"5","author":[{"given":"JaHyun","family":"Kang","sequence":"first","affiliation":[{"name":"College of Nursing, Seoul National University, Seoul, Korea"},{"name":"Research Institute of Nursing Science, Seoul National University, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunjeong","family":"Ji","sequence":"additional","affiliation":[{"name":"Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junghee","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunok","family":"Bae","sequence":"additional","affiliation":[{"name":"Office of Digital Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunyoung","family":"Cho","sequence":"additional","affiliation":[{"name":"Office of Digital Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eu Suk","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea"},{"name":"Center for Infection Control, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea"},{"name":"Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myoung Jin","family":"Shin","sequence":"additional","affiliation":[{"name":"Center for Infection Control, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong Bin","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea"},{"name":"Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2022,3,10]]},"reference":[{"issue":"8","key":"zoi220082r2","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1086\/666629","article-title":"Resource burden associated with contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus: the patient access managers\u2019 perspective.","volume":"33","author":"Shenoy","year":"2012","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"1","key":"zoi220082r3","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1017\/ice.2014.1","article-title":"Cost-benefit analysis from the hospital perspective of universal active screening followed by contact precautions for methicillin-resistant Staphylococcus aureus carriers.","volume":"36","author":"McKinnell","year":"2015","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"4","key":"zoi220082r4","doi-asserted-by":"publisher","first-page":"561","DOI":"10.3201\/eid1004.020754","article-title":"Economics and preventing hospital-acquired infection.","volume":"10","author":"Graves","year":"2004","journal-title":"Emerg Infect Dis"},{"issue":"1","key":"zoi220082r5","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1086\/663340","article-title":"Association between contact precautions and delirium at a tertiary care center.","volume":"33","author":"Day","year":"2012","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"14","key":"zoi220082r6","doi-asserted-by":"publisher","first-page":"1899","DOI":"10.1001\/jama.290.14.1899","article-title":"Safety of patients isolated for infection control.","volume":"290","author":"Stelfox","year":"2003","journal-title":"JAMA"},{"issue":"10","key":"zoi220082r7","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1086\/673143","article-title":"Effects of contact precautions on patient perception of care and satisfaction: a prospective cohort study.","volume":"34","author":"Mehrotra","year":"2013","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"3","key":"zoi220082r8","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1086\/675295","article-title":"On contact precautions: the good, the bad, and the ugly.","volume":"35","author":"Anderson","year":"2014","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"7","key":"zoi220082r9","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1086\/676534","article-title":"Strategies to prevent methicillin-resistant Staphylococcus aureus transmission and infection in acute care hospitals: 2014 update.","volume":"35","author":"Calfee","year":"2014","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"3","key":"zoi220082r10","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1093\/cid\/cis398","article-title":"Uncertainty in the application of contact precautions.","volume":"55","author":"Morgan","year":"2012","journal-title":"Clin Infect Dis"},{"issue":"6","key":"zoi220082r11","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1017\/ice.2018.57","article-title":"Impact of discontinuing contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus: an interrupted time series analysis.","volume":"39","author":"Bearman","year":"2018","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"10","key":"zoi220082r12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bmjqs-2018-008926","article-title":"The discontinuation of contact precautions for methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus: impact upon patient adverse events and hospital operations.","volume":"29","author":"Schrank","year":"2020","journal-title":"BMJ Qual Saf"},{"issue":"12","key":"zoi220082r13","doi-asserted-by":"publisher","first-page":"1466","DOI":"10.1016\/j.ajic.2020.06.219","article-title":"Stopping the routine use of contact precautions for management of MRSA and VRE at three academic medical centers: an interrupted time series analysis.","volume":"48","author":"Haessler","year":"2020","journal-title":"Am J Infect Control"},{"issue":"3","key":"zoi220082r14","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/j.jhin.2014.09.003","article-title":"Impact of contact precautions on falls, pressure ulcers and transmission of MRSA and VRE in hospitalized patients.","volume":"88","author":"Gandra","year":"2014","journal-title":"J Hosp Infect"},{"issue":"7","key":"zoi220082r15","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1017\/ice.2018.93","article-title":"Noninfectious hospital adverse events decline after elimination of contact precautions for MRSA and VRE.","volume":"39","author":"Martin","year":"2018","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"3","key":"zoi220082r16","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1007\/s11606-016-3862-4","article-title":"The effect of hospital isolation precautions on patient outcomes and cost of care: a multi-site, retrospective, propensity score-matched cohort study.","volume":"32","author":"Tran","year":"2017","journal-title":"J Gen Intern Med"},{"issue":"11","key":"zoi220082r17","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.1017\/ice.2015.192","article-title":"The effect of contact precautions on frequency of hospital adverse events.","volume":"36","author":"Croft","year":"2015","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"2","key":"zoi220082r18","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1017\/ice.2017.245","article-title":"Duration of contact precautions for acute-care settings.","volume":"39","author":"Banach","year":"2018","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"7","key":"zoi220082r21","doi-asserted-by":"publisher","first-page":"974","DOI":"10.1016\/j.ijnurstu.2012.11.019","article-title":"Patient risk factors for pressure ulcer development: systematic review.","volume":"50","author":"Coleman","year":"2013","journal-title":"Int J Nurs Stud"},{"issue":"4","key":"zoi220082r22","first-page":"421","article-title":"Quality of care and satisfaction among patients isolated for infection control.","volume":"291","author":"Weber","year":"2004","journal-title":"JAMA"},{"issue":"5","key":"zoi220082r23","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1001\/jamainternmed.2014.537","article-title":"Do physicians spend less time with patients in contact isolation?: a time-motion study of internal medicine interns.","volume":"174","author":"Dashiell-Earp","year":"2014","journal-title":"JAMA Intern Med"},{"issue":"1","key":"zoi220082r24","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1086\/668775","article-title":"The effect of contact precautions on healthcare worker activity in acute care hospitals.","volume":"34","author":"Morgan","year":"2013","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"2","key":"zoi220082r25","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1097\/EDE.0000000000000595","article-title":"A propensity-score-based fine stratification approach for confounding adjustment when exposure is infrequent.","volume":"28","author":"Desai","year":"2017","journal-title":"Epidemiology"},{"key":"zoi220082r26","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1002\/pds.3263","article-title":"One-to-many propensity score matching in cohort studies.","volume":"21","author":"Rassen","year":"2012","journal-title":"Pharmacoepidemiol Drug Saf"},{"issue":"4","key":"zoi220082r28","first-page":"420","article-title":"Quality of care and satisfaction among patients isolated for infection control.","volume":"291","author":"Safdar","year":"2004","journal-title":"JAMA"},{"issue":"5","key":"zoi220082r29","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1002\/sim.8008","article-title":"Propensity-score matching with competing risks in survival analysis.","volume":"38","author":"Austin","year":"2019","journal-title":"Stat Med"},{"issue":"5","key":"zoi220082r31","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1097\/00006199-199809000-00005","article-title":"Predicting pressure ulcer risk: a multisite study of the predictive validity of the Braden Scale.","volume":"47","author":"Bergstrom","year":"1998","journal-title":"Nurs Res"},{"issue":"11","key":"zoi220082r32","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1097\/01.NAJ.0000298062.27349.8e","article-title":"How to try this: predicting patient falls. using the Hendrich II Fall Risk Model in clinical practice.","volume":"107","author":"Hendrich","year":"2007","journal-title":"Am J Nurs"},{"issue":"3","key":"zoi220082r33","doi-asserted-by":"publisher","DOI":"10.3912\/OJIN.Vol12No03Man02","article-title":"The National Database of Nursing Quality Indicators\u00ae (NDNQI\u00ae).","volume":"12","author":"Montalvo","year":"2007","journal-title":"The Online Journal of Issues in Nursing"},{"issue":"24","key":"zoi220082r34","doi-asserted-by":"publisher","first-page":"2255","DOI":"10.1056\/NEJMoa1207290","article-title":"Targeted versus universal decolonization to prevent ICU infection.","volume":"368","author":"Huang","year":"2013","journal-title":"N Engl J Med"},{"issue":"10177","key":"zoi220082r35","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.1016\/S0140-6736(18)32593-5","article-title":"Chlorhexidine versus routine bathing to prevent multidrug-resistant organisms and all-cause bloodstream infections in general medical and surgical units (ABATE Infection trial): a cluster-randomised trial.","volume":"393","author":"Huang","year":"2019","journal-title":"Lancet"},{"issue":"2","key":"zoi220082r36","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1016\/j.outlook.2014.08.005","article-title":"Comparing the nurse staffing in Korean and U.S. nursing homes.","volume":"63","author":"Lee","year":"2015","journal-title":"Nurs Outlook"},{"issue":"2","key":"zoi220082r37","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1097\/01.NCQ.0000263099.21558.ec","article-title":"Magnet status: a journey, not a destination.","volume":"22","author":"Broom","year":"2007","journal-title":"J Nurs Care Qual"},{"issue":"1","key":"zoi220082r38","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.jclinepi.2014.09.010","article-title":"A systematic review identifies valid comorbidity indices derived from administrative health data.","volume":"68","author":"Yurkovich","year":"2015","journal-title":"J Clin Epidemiol"},{"issue":"9","key":"zoi220082r39","doi-asserted-by":"publisher","first-page":"2878","DOI":"10.1007\/s11999-014-3686-7","article-title":"The Elixhauser comorbidity method outperforms the Charlson index in predicting inpatient death after orthopaedic surgery.","volume":"472","author":"Menendez","year":"2014","journal-title":"Clin Orthop Relat Res"},{"key":"zoi220082r40","doi-asserted-by":"publisher","first-page":"S637","DOI":"10.21037\/jtd.2016.08.44","article-title":"Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital.","volume":"8","author":"Yoo","year":"2016","journal-title":"J Thorac Dis"},{"key":"zoi220082r1","doi-asserted-by":"crossref","unstructured":"Siegel? JD, Rhinehart? E, Jackson? M, Chiarello? L; the Healthcare Infection Control Practices Advisory Committee. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in health care settings. CDC. Published 2007. Accessed May 7, 2020. https:\/\/www.cdc.gov\/infectioncontrol\/pdf\/guidelines\/isolation-guidelines-H.pdf","DOI":"10.1016\/j.ajic.2007.10.007"},{"key":"zoi220082r19","unstructured":"CMS. Quality measures fact sheet: CMS patient safety indicators PSI 90 (NQF #0531): national quality strategy domain: patient safety. Published 2019. Accessed October 2, 2020. https:\/\/innovation.cms.gov\/files\/fact-sheet\/bpciadvanced-fs-psi90.pdf"},{"key":"zoi220082r20","unstructured":"National Quality Forum. Patient safety measures: complications. Published 2013. Accessed October 2, 2020. https:\/\/www.qualityforum.org\/Projects\/n-r\/Patient_Safety_Measures_Complications\/Patient_Safety_Measures_Complications.aspx"},{"key":"zoi220082r27","unstructured":"Desai? R.? Propensity score fine stratifiction SAS macro.? Harvard Dataverse. Published 2020. Accessed November 21, 2020. https:\/\/dataverse.harvard.edu\/dataset.xhtml?persistentId=doi:10.7910\/DVN\/U8JLCW"},{"key":"zoi220082r30","unstructured":"American Academy of Family Physicians. Braden Scale. Accessed May 5, 2021. https:\/\/www.aafp.org\/afp\/2008\/1115\/afp20081115p1186-s1.pdf"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2789908\/kang_2022_oi_220082_1765204973.38115.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T16:00:45Z","timestamp":1765468845000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2789908"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,10]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2022.1865","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,10]]}}}