Skip to main content Accessibility help
×
×
Home

Patient isolation for infection control and patient experience

  • Zishan K. Siddiqui (a1), Sarah Johnson Conway (a1), Mohammed Abusamaan (a1), Amanda Bertram (a1), Stephen A. Berry (a2), Lisa Allen (a3), Ariella Apfel (a1), Holley Farley (a4), Junya Zhu (a5), Albert W. Wu (a1) and Daniel J. Brotman (a1)...

Abstract

Objective

Hospitalized patients placed in isolation due to a carrier state or infection with resistant or highly communicable organisms report higher rates of anxiety and loneliness and have fewer physician encounters, room entries, and vital sign records. We hypothesized that isolation status might adversely impact patient experience as reported through Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys, particularly regarding communication.

Design

Retrospective analysis of HCAHPS survey results over 5 years.

Setting

A 1,165-bed, tertiary-care, academic medical center.

Patients

Patients on any type of isolation for at least 50% of their stay were the exposure group. Those never in isolation served as controls.

Methods

Multivariable logistic regression, adjusting for age, race, gender, payer, severity of illness, length of stay and clinical service were used to examine associations between isolation status and “top-box” experience scores. Dose response to increasing percentage of days in isolation was also analyzed.

Results

Patients in isolation reported worse experience, primarily with staff responsiveness (help toileting 63% vs 51%; adjusted odds ratio [aOR], 0.77; P = .0009) and overall care (rate hospital 80% vs 73%; aOR, 0.78; P < .0001), but they reported similar experience in other domains. No dose-response effect was observed.

Conclusion

Isolated patients do not report adverse experience for most aspects of provider communication regarded to be among the most important elements for safety and quality of care. However, patients in isolation had worse experiences with staff responsiveness for time-sensitive needs. The absence of a dose-response effect suggests that isolation status may be a marker for other factors, such as illness severity. Regardless, hospitals should emphasize timely staff response for this population.

Copyright

Corresponding author

Author for correspondence: Sarah Johnson Conway MD, 600 N Wolfe Street, Meyer 8-145, Baltimore, MD 21287. E-mail: sjohn207@jhmi.edu

Footnotes

Hide All

PREVIOUS PRESENTATION: These findings were previously presented as a poster at the Society of Hospital Medicine 2018 Annual Conference on April 9, 2018, in Orlando, Florida.

Cite this article: Siddiqui ZK, et al. (2019). Patient isolation for infection control and patient experience. Infection Control & Hospital Epidemiology 2019, 40, 194–199. doi: 10.1017/ice.2018.324

Footnotes

References

Hide All
1. Siegel, JD, Rhinehart, E, Jackson, M, Chiarello, L. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings. Centers for Disease Control and Prevention website. https://www.cdc.gov/niosh/docket/archive/pdfs/NIOSH-219/0219-010107-siegel.pdf. Accessed January 17, 2017.
2. Evans, HL, Shaffer, MM, Hughes, MG, et al. Contact isolation in surgical patients: a barrier to care? Surgery 2003;134:180188. doi:10.1067/msy.2003.222.
3. Kirkland, KB, Weinstein, JM. Adverse effects of contact isolation. Lancet 1999;354:11771178. doi:10.1016/S0140-6736(99)04196-3.
4. Saint, S, Higgins, LA, Nallamothu, BK, Chenoweth, C. Do physicians examine patients in contact isolation less frequently? A brief report Sanjay Saint. Am J Infect Control 2003;31:354356.
5. Stelfox, HT, Bates, DW, Redelmeier, DA. Safety of patients isolated for infection control. JAMA. 2003;290:1899.
6. Lupión-Mendoza, C, Antúnez-Domínguez, MJ, González-Fernández, C, Romero-Brioso, C, Rodriguez-Bano, J. Effects of isolation on patients and staff. Am J Infect Control 2015;43:397399.
7. Maunder, R, Hunter, J, Vincent, L, et al. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ 2003;168:12451251.
8. Catalano, G, Houston, SH, Catalano, MC, et al. Anxiety and depression in hospitalized patients in resistant organism isolation. South Med J 2003;96:141145.
9. Gammon, J. Analysis of the stressful effects of hospitalisation and source isolation on coping and psychological constructs. Int J Nurs Pract 1998;4:8496.
10. MacKellaig, JM. A study of the psychological effects of intensive care with particular emphasis on patients in isolation. Intensive Care Nurs 1987;2:176185.
11. Gasink, LB, Singer, K, Fishman, NO, et al. Contact isolation for infection control in hospitalized patients: Is patient satisfaction affected? Infect Control Hosp Epidemiol 2008;29:275278.
12. Mehrotra, P, Croft, L, Day, HR, et al. Effects of contact precautions on patient perception of care and satisfaction: a prospective cohort study. Infect Control Hosp Epidemiol 2013;34:10871093.
13. Livorsi, DJ, Kundu, MG, Batteiger, B, Kressel, AB. Effect of contact precautions for MRSA on patient satisfaction scores. J Hosp Infect 2015;90:263266.
14. Vinski, J, Bertin, M, Sun, Z, et al. Impact of isolation on hospital consumer assessment of healthcare providers and systems scores: Is isolation isolating? Infect Control Hosp Epidemiol 2012;33:513516.
15. Centers for Medicare and Medicaid Services. CAHPS Hospital Survey (HCAHPS): Quality Assurance Guidelines. Consumer Assessment of Healthcare Providers and Systems website. http://www.hcahpsonline.org/globalassets/hcahps/quality-assurance/2018_qag_v13.0.pdf. Accessed June 3, 2018.
16. Hospital Compare datasets. Centers for Medicare and Medicaid Services website. https://data.medicare.gov/data/hospital-compare. Accessed October 30, 2018.
17. Siddiqui, ZK, Zuccarelli, R, Durkin, N, Wu, AW, Brotman, DJ. Changes in patient satisfaction related to hospital renovation: experience with a new clinical building. J Hosp Med. 2015;10:165171.
18. Sofaer, S, Crofton, C, Goldstein, E, Hoy, E, Crabb, J. What do consumers want to know about the quality of care in hospitals? Health Serv Res 2005;40:20182036.
19. Elliott, MN, Kanouse, DE, Edwards, CA, Hilborne, LH. Components of care vary in importance for overall patient-reported experience by type of hospitalization. Med Care 2009;47:842849.
20. Ahmadi Kashkoli, S, Zarei, E, Daneshkohan, A, Khodakarim, S. Hospital responsiveness and its effect on overall patient satisfaction. Int J Health Care Qual Assur 2017;30:728736.
21. Meade, CM, Bursell, AL, Ketelsen, L. Effects of nursing rounds: on patients’ call light use, satisfaction, and safety. Am J Nurs 2006;106:5870.
22. Go, S, Thomasson-Waters, J, Law, E. Improving patient satisfaction by changing patients’ percpetions of staff responsiveness on a cardiac telemetry unit. Cone Health website. https://www.conehealth.com/app/files/public/7258/34-improving-patient-satisfactionby-changing-patients-perception-of-staff-responsiveness.pdf. Accessed March 20, 2018.
23. Williams, DB. Improving Staff Responsiveness to Patient-Initiated Call Lights. San Francisco, CA; 2014.
24. Elliott, MN, Zaslavsky, AM, Goldstein, E, et al. Effects of Survey Mode, Patient Mix, and Nonresponse on CAHPS Hospital Survey Scores. Health Serv Res 2009;44:501518.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed