Brief report
Effects of isolation on patients and staff

https://doi.org/10.1016/j.ajic.2015.01.009Get rights and content

Highlights

  • Adverse effects related to isolation were investigated by quantitative and qualitative methods.

  • A matched case-control study found isolation to be a predictor of depression.

  • Healthcare workers recognised being less responsive to isolated patients.

A matched case-control study and a qualitative investigation were used to identify adverse events in diverse dimensions associated with isolation. Overall satisfaction with care was similar among patients in isolation, but staff was found to be less responsive. Isolation was also associated with depression, but not with increased anxiety.

Section snippets

Methods

The study was performed during 2011 and 2012 in a 900-bed tertiary hospital with an active infection control program.2, 3 Routine procedures include an infection control nurse informs patients and relatives of the reasons for isolation and the measures; specific messages are given with the aim of reducing anxiety or guilt feelings and the information is reinforced during admission according to perceived needs. Health care workers (HCWs) receive reinforcement training about the specific measures

Results

Seventy-two pairs of cases and controls were included. Among the cases, the reasons for isolation were contact precautions in 58 patients (80.6%), and airborne precautions in 14 patients (19.4%); 43 patients (59.7 %) were admitted to medical units and 29 patients (40.3%) were admitted to surgical units. The baseline features, perception of care, chart records, adverse events, and results of the HADS questionnaire are shown in Table 1. All patients answered all the questions. After controlling

Discussion

We used 2 complementary designs to explore the implications of isolation, including patient satisfaction with care, recording of data on medical charts, adverse events, and psychological effects. Unlike previous studies,1, 8 patients in isolation in our center did not show a worse level of satisfaction with the care provided, but noticed a lower responsiveness from HCWs, as reflected by the facts that HCWs tended to enter the rooms less frequently, patients' food trays took longer to be

Conclusions

Despite the measures undertaken in our practice to limit the adverse effects of isolation, some specific problems were disclosed. Interventions to limit the effects of isolation should be implemented in all centers.

Acknowledgments

This study was supported by a grant from Consejería de Salud, Junta de Andalucía (SAS 111240) and Ministerio de Economía y Competitividad, Instituto de Salud Carlos III and cofinanced by the European Development Regional Fund “A way to achieve Europe” and the Spanish Network for the Research in Infectious Diseases (RD12/0015).

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Conflicts of interest: None to report.

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