Terms used for isolation practices by nurses at an academic medical center

Abstract

Aim This paper is a report of a study to determine if the terms used by nurses to describe isolation precautions are associated with correct identification of required personal protective equipment. Background Isolation measures are important in the prevention of health care-associated infections. The terms used to describe categories of isolation have changed in response to new pathogens and with advances in infection prevention. Methods For three months in2009, nurses from an academic medical center on the East Coast of the United States of America completed a survey consisting of ten clinical scenarios which asked about recommended personal protective equipment and for the name of the recommended isolation type. Correct identification of required personal protective equipment was compared to use of an approved isolation category term, controlling for infection knowledge and demographic variables. Results Three hundred and seventeen nurses gave responses to2, 215 clinical scenarios. Use of non-approved category terms was associated with statistically significantly lower rates of correct personal protective equipment identification compared to use of an approved term (62.2% vs. 77.8%; p<.001). Specific PPE was also selected for use when not indicated--including gowns (42%), N-95 respirators (13%), fluid shield masks(13%) and sterile gloves (6%). Conclusion Inconsistent terminology for isolation precautions may contribute to variations in practice. Adoption of internationally-accepted and standardized category terms may improve adherence to these precautions.

Personal Protective Equipment in Hospital Nursing Care: A Scoping Review

“…Of the 19 articles included in the final sample, ten were identified in PUBMED [24][25][26][27][28][29][30][31][32][33] , three in LILACS/BDENF [34][35][36] , and two in SCOPUS [37][38] , EMBASE [39][40] and CINAHL [41][42] each. Six publications were chosen in the gray literature: three from the CDC [43][44][45] , two from the WHO [46][47] and one from the American Society of Health-system Pharmacists (ASHP) 48 .…”

“…The United States of America stands out among the most predominant countries with 10 studies published in the scientific literature [41][42][25][26][27]33 and from the gray literature [43][44][45][46]48 (Chart 1). As for the years of publication of the studies, they are presented in a diversified way with greater predominance of 2019 (n=4) and 2016 (n=3).…”

“…Most of the studies had a quantitative and cross-sectional approach 24,[26][27][28][29][30][33][34][35][38][39][40][41][42] , followed by qualitative research studies 25,[31][32]36,37 , and only one mixed-methods study 24 . Although most of the authors include the definitions of the approaches and/or method, some did not do so 28,38 .…”

“…In relation to the context, the studies included health and safety in the face of biological and pharmacological agents. As for diseases and/or biological agents, the following were identified: Tuberculosis 27,31,39 , HIV/AIDS 36,38 , Hepatitis B and Hepatitis C 38 , Clostridium Difficile, MRSA, Chickenpox, Flu and Meningococcal Meningitis 27 and COVID-19 24 . As for the medications, antineoplastics 33,37,40,42,[44][45]48 , air sprayers 41 and cytotoxics 43 were studied.…”

Documentation of Contact Precautions in an Electronic Health Record

“…Consistency of nursing documentation for CP can be improved by constraining the choices of isolation categories to a uniform list. 24 …”