Care of Children Isolated for Infection Control: A Prospective Observational Cohort Study

Cohen, Eyal; Austin, Janice; Weinstein, Michael; Matlow, Anne; Redelmeier, Donald A.

doi:10.1542/peds.2008-0181

Cited by 26 publications

(33 citation statements)

References 10 publications

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“…Es entspricht im Gegenteil einer häufigen klinischen Erfahrung, dass in diesem Kontext angemessen betreute Patienten sich besonders sicher füh-len und den ihnen zugemessenen Mehraufwand als positiv empfinden [339]. Dazu ist es nötig, den Patienten und ihren Angehörigen die Gründe für die Hygienemaßnahmen sorgfältig zu erläutern und Vorkehrungen zu treffen, um eine schlechtere medizinische Betreuung zu vermeiden [340].…”

Section: Kastenunclassified

Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen

Ruscher

2014

Bundesgesundheitsbl.

125

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Section: Kastenunclassified

Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen

Ruscher

2014

Bundesgesundheitsbl.

125

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“…1,4,5,9,10,27,28,31,34,36,37,39,40,42 There were two studies that included children. 2,26 Most of the studies were located in the general ward; two were undertaken in the intensive care unit, 5,32 and two involved both sites. 1,34 For all included studies, the reason for isolation was infection.…”

Section: Resultsmentioning

confidence: 99%

“…10,31,36,39,40 Three reported infection with either hospital-acquired or multidrug-resistant organisms. 1,5,26 One used protective isolation for severe acute respiratory syndrome (SARS), 34 and the remaining studies used isolation for infections by several different organisms including Salmonella spp., Clostridium difficile, Scabies spp., and Mycobacterium tuberculosis. 27,28,37,42 Three did not identify the specific type of infections.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Adverse effects of isolation in hospitalised patients: a systematic review

Abad

Fearday

Safdar

2010

Journal of Hospital Infection

433

346

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The use of transmission precautions such as contact isolation in patients known to be colonised or infected with multidrug-resistant organisms is recommended in healthcare institutions. Although essential for infection control, contact isolation has recently been associated with adverse effects in patients. We undertook a systematic review to determine whether contact isolation leads to psychological or physical problems for patients. Studies were included if (1) hospitalised patients were placed under isolation precautions for an underlying medical indication, and (2) any adverse events related to the isolation were evaluated. We found 16 studies that reported data regarding the impact of isolation on patient mental well-being, patient satisfaction, patient safety or time spent by healthcare workers in direct patient care. The majority showed a negative impact on patient mental well-being and behaviour, including higher scores for depression, anxiety and anger among isolated patients. A few studies also found that healthcare workers spent less time with patients in isolation. Patient satisfaction was adversely affected by isolation if patients were kept uninformed of their healthcare. Patient safety was also negatively affected, leading to an eight-fold increase in adverse events related to supportive care failures. We found that contact isolation may negatively impact several dimensions of patient care. Well-validated tools are necessary to investigate these results further. Large studies examining a number of safety indicators to assess the adverse effects of isolation are needed. Patient education may be an important step to mitigate the adverse psychological effects of isolation and is recommended.

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“…The present study suggests that, in isolation, measures to restrict the use of pacifiers in hospital are unlikely to affect the incidence of ND in such settings. Health professionals should thus focus on known effective measures, such as hand washing, and look for factors other than the use of pacifiers in their efforts to prevent spread of diarrhoeal pathogens in the hospital 2 13 14…”

Section: Discussionmentioning

confidence: 99%

Do pacifiers increase the risk of nosocomial diarrhoea? A cohort study

Sette

Mello²,

Correia³

et al. 2012

BMJ Open

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DesignProspective cohort study.SettingTeaching paediatric hospital—Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Northeast Brazil.Participants378 of 536 infants admitted in paediatric wards from April to October 2009 were daily assessed during hospital stay until the first episode of nosocomial diarrhoea (ND), death or discharge. Infants with community-acquired diarrhoea, respiratory or haemodynamic instability and who stayed in hospital for <24 h were excluded.Primary and secondary outcome measuresIncidence and risk factors for ND and rates of pacifier faecal contamination.Results33 ND episodes occurred in 378 infants, with a cumulative incidence of 8.7% and density of 11.25/1000 patients-day. ND occurred in 8.2% (16/194) of pacifier users compared with 9.2% (17/184) in non-users (adjusted OR=0.88, 95% CI 0.43 to 1.80). In multivariate logistic regression analysis, duration of oxygen use (OR=1.61; 95% CI 1.18 to 2.20) and days of antimicrobial use (OR=1.62, 95% CI 1.34 to 1.94) were associated with higher risk of ND, whereas being breast fed (OR=0.40, 95% CI 0.17 to 0.93) and each day of hospital stay (OR=0.65, 95% CI 0.53 to 0.80) were protective factors. Faecal coliforms were isolated in 16% (27/169) of tested pacifiers, 77.8% of which had more than 100 000 CFU/ml. The probability of a child remaining free of an episode of diarrhoea up to the seventh day of hospitalisation in the ward was 91.2% (95% CI 87.7% to 94.9%). The log-rank test showed no statistical difference between pacifier users and non-users.ConclusionsND is a frequent healthcare-associated infection in paediatric wards, but the use of pacifiers during the stay in hospital does not seem to affect the incidence of ND in infants in many settings where the burden of diarrhoea is still high.

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Care of Children Isolated for Infection Control: A Prospective Observational Cohort Study

Abstract: No large differences in quality or quantity of care were observed between isolated and nonisolated patients in the first 2 days of admission to a pediatric ward.

Cited by 26 publications

References 10 publications

Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen

Empfehlungen zur Prävention und Kontrolle von Methicillin-resistenten Staphylococcus aureus-Stämmen (MRSA) in medizinischen und pflegerischen Einrichtungen

Adverse effects of isolation in hospitalised patients: a systematic review

Do pacifiers increase the risk of nosocomial diarrhoea? A cohort study

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