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Isolating infectious patients: Organisational, clinical and ethical issues

Research output: Contribution to journalArticle

Dinah Gould, N.S. Drey, Jane Chudleigh, Marco-Felipe King, Neil Wigglesworth, Edward Purssell

Original languageEnglish
JournalAmerican Journal of Infection Control
Early online date27 Jun 2018
DOIs
Accepted/In press30 May 2018
E-pub ahead of print27 Jun 2018

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Abstract

Background: Isolating infectious patients is essential to reduce infection risk. Effectiveness depends on identifying them, transfer to suitable accommodation and maintaining precautions.
Methods: Online study to address identification of infectious patients, transfer and challenges maintaining isolation in hospitals in the United Kingdom.
Results: Forty nine responses were obtained. Decision to isolate is taken between infection prevention teams, clinicians and managers. Respondents reported situations where isolation was impossible because of the patient’s physical condition or cognitive status. Very sick patients and those with dementia were not thought to tolerate isolation well. Patients were informed about need for isolation by ward nurses, sometimes with explanation from infection prevention teams. Explanations were often poorly received and comprehended, fuelling complaints. Respondents were aware of ethical dilemmas associated with isolation undertaken in the interests of other health service users and society. Organisational failures could delay instigating isolation. Records were kept of demand for isolation and/or uptake but quality was variable.
Conclusion: Isolation has received greatest attention in countries with under-provision of accommodation. Our study demonstrates reasons for delays identifying patients and isolation failure placing others at risk that apply in any organisation regardless of availability and highlights ethical dilemmas of enforcing isolation.

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