Why Patients in Isolation Feel More Isolated
abstract & commentary
Synopsis: The significant reduction in staff contact in this study supports the findings of other investigators that patients in isolation feel—more isolated.
Source: Kirkland KB, Weinstein JM. Lancet 1999;354: 1177-1178.
Kirkland and weinstein assessed the handwashing compliance of and the frequency of contact between the physician and nursing staff at Duke University and 14 patients in contact isolation (e.g., gowns and gloves) compared with 21 patients who were not in isolation. Data were assessed over a one-hour period per patient. While the staff compliance with gowns and gloves was remarkably good (90%) for patients in isolation, the rate of physician and nursing staff contact with these patients was only half that for nonisolation patients (2.1 vs 4.2 contacts/hr; P = 0.03). In addition, fewer health care workers entered the room if a patient was in isolation.
On a positive note, health care workers were more than twice as likely to wash their hands when encountering a patient in isolation compared with nonisolation subjects (90% vs 40%). Most of the staff were observed washing their hands following contact with a patient in isolation and only 7% washed their hands before contact. Because of this, Kirkland and Weinstein questioned whether the staff were possibly more concerned about their own health or that of their patients.
Comment by Carol A. Kemper, MD
I suspect that staff, while making rounds, wash their hands between patients, an observation that may not have been captured by this study. Whether restricting patients to isolation affects the quality of the care is not clear, but the significant reduction in staff contact in this study supports the findings of other investigators that patients in isolation feel—more isolated. (Dr. Kemper is Clinical Associate Professor of Medicine, Stanford University, Division of Infectious Diseases, Santa Clara Valley Medical Center.)
Health care workers were more than twice as likely to wash their hands when encountering a patient in isolation compared with nonisolation.
a. True
b. False
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