Adverse effects of contact isolation

Methicillin-resistant Staphylococcus aureus (MRSA) management in palliative care units and hospices in Germany: A nationwide survey on patient isolation policies and quality of life

“…19,20 A North American cohort study raised the concern of inferior care of isolated patients, 21 and two observational studies from the US recorded significantly less health care provider/ patient contact in isolated than in non-isolated patients. 22,23 The results of our global assessment of current MRSA containment policies in German palliative care institutions do add evidence from a professional caregivers' and institutional perspective to the cross-border notion of negative effects of such policies on patients both in the palliative care 5,7,8 and in other settings. 1,2,18 Next steps should begin with conducting a multi-centre mixed-method investigation of affected patients' and relatives' opinions on their experience of the MRSA regimen to estimate the magnitude of the problem within the palliative care settings.…”

“…In the policy section, information was requested regarding existence of a formal MRSA protocol (7), barriers to admission or discharge of MRSA-positive patients (8), routine MRSA screening on admission (9), isolation of MRSA-positive patients (10), precautions taken by staff caring for MRSA-positive patients (11), MRSA screening of staff (12), information policy for MRSA-positive patients (13) and visitors (14), preventive measures for visitors (15), restrictions of mobility and social activities of MRSA-positive patients (16), treatment policy of MRSA colonization (17), possible contraindications against MRSA eradication therapy (18), laboratory control of MRSA eradication therapy (19), and screening on re-hospitalization of a formerly MRSApositive patient (20). In the final section on clinical relevance, questions asked whether an existing MRSA protocol was adhered to (21), whether respondents felt such a protocol would influence the patients' quality of life (22), and whether eradication protocols were of importance for inpatient treatment in PCUs or hospices (23).…”

Infection Control Issues in Older Adults

“…Several recent investigations also have challenged the quality of care provided to patients in isolation. One study found that isolated patients were twice as likely as control patients to experience adverse events during hospitalization [6,7]. Isolated patients also were more likely to complain about their care, not having their vital signs recorded as ordered, and have days with no physician progress notes [6].…”

Double Jeopardy: Use of Contact Isolation in Trauma Patients is Significantly Associated with the Development of Ileus

“…As the isolated patient is restricted to their room throughout ambulation trials, we believe that this policy likely discouraged early return to effective mobilization both directly (i.e., due to the small space of the hospital room) and indirectly by effecting fewer occupational and physical therapy visits. Although there should ideally be no difference in the quality or quantity of medical attention that isolated patients receive from staff, evidence has shown that these patients typically receive fewer visits of shorter duration from both nursing and physician staff throughout their stay [12]. This is likely an effect of the increased burden of each visit due to the requirement of donning a gown and gloves with each visit.…”

“…Many institutions also restrict isolated patients to their room for all non-medically essential activities (including occupational and physical therapies) throughout their stay. Recently, some potentially negative side effects of contact isolation have been described [12,13]. While most of this literature has focused on general hospital inpatients, more recent studies have begun to show that there may be an especially negative impact on surgical and trauma patients [14,15].…”