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Adapting Disease-Specific Isolation Guidelines to a Hospital Information System

Published online by Cambridge University Press:  02 January 2015

Julie T. Jacobson*
Affiliation:
Division of Infectious Disease, Department of Internal Medicine, the Department of Medical Biophysics and Computing;LDS Hospital;and the Department of Internal Medicine, University of Utah School of Medicine; Salt Lake City, Utah
Dickey S. Johnson
Affiliation:
Division of Infectious Disease, Department of Internal Medicine, the Department of Medical Biophysics and Computing;LDS Hospital;and the Department of Internal Medicine, University of Utah School of Medicine; Salt Lake City, Utah
Carol A. Ross
Affiliation:
Division of Infectious Disease, Department of Internal Medicine, the Department of Medical Biophysics and Computing;LDS Hospital;and the Department of Internal Medicine, University of Utah School of Medicine; Salt Lake City, Utah
Marlyn T. Conti
Affiliation:
Division of Infectious Disease, Department of Internal Medicine, the Department of Medical Biophysics and Computing;LDS Hospital;and the Department of Internal Medicine, University of Utah School of Medicine; Salt Lake City, Utah
R. Scott Evans
Affiliation:
Division of Infectious Disease, Department of Internal Medicine, the Department of Medical Biophysics and Computing;LDS Hospital;and the Department of Internal Medicine, University of Utah School of Medicine; Salt Lake City, Utah
John R Burke
Affiliation:
Division of Infectious Disease, Department of Internal Medicine, the Department of Medical Biophysics and Computing;LDS Hospital;and the Department of Internal Medicine, University of Utah School of Medicine; Salt Lake City, Utah
*
Division of Infectious Disease, LDS Hospital, Eighth Avenue and C Street, Salt Lake City, UT 84143

Abstract

The authors modified the Centers for Disease Control's guideline for disease-specific isolation precautions to a hospital computerized information system. Entering a suspected diagnosis selected from the isolation option on computer terminals generated: 1) a printout listing the isolation instructions, infective material(s), and persons who should avoid exposure; 2) an order for the appropriate supplies; 3) a patient charge based on the supplies required; and 4) an option for stopping, changing, or listing the orders. In order to implement this system, both extensive in-service training for nurses and efforts to change ordering practices of physicians were necessary.

Prevalence surveys before and after computerization were used to evaluate the new system. Combined surveys showed that isolation was ordered for only 21% of patients when indicated. Failure to isolate was identified as a significant problem. As a consequence, continuous surveillance and consultation of all infected patients were instituted, resulting in isolation orders for 81% when indicated. The computerized disease-specific system has resulted in better and more accurate use of isolation, probably due to in service education and surveillance efforts.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1986

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References

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