The Utility of Preliminary Patient Evaluation in a Febrile Respiratory Infectious Disease Unit outside the Emergency Department

Kang, Jun Sik; Jhun, Byung Woo; Yoon, Hee; Lim, Seong Mi; Ko, Eunsil; Park, Joo Hyun; Hwang, Sung Yeon; Lee, Se Uk; Lee, Tae Rim; Cha, Won Chul; Shin, Tae Gun; Sim, Min Seob; Jo, Ik Joon

The most important findings of our study were that the isolation levels determined based on initial FRIDU screening were moderately well correlated with the isolation levels required by the final diagnoses. And FRIDU screening had high NPV for diagnosing contagious disease requiring isolation, demonstrating the utility of pre-hospitalization screening units. Of 97 patients diagnosed with contagious diseases requiring isolation, 74 patients were isolated and 5 patients were reverse isolated, and all of the 5 patients had had both neutropenia and influenza. Of 18 patents who were non-isolated, 16 had a negative result of influenza antigen test at initial FRIDU but they subsequently were confirmed to have respiratory virus infection during hospitalization by PCR test. Additionally, 143 of 207 immunocompromised patients were reverse isolated based on FRIDU screening. Actually, more than two-thirds of the 60 immunocompromised patients, who were categorized into non-isolation based on FRIDU screening, were observed in their own bed with curtain and reverse isolation notice, due to the lack of revere isolation room. Of them, patients who had respiratory symptoms such as cough, sputum mandatorily had to wear a surgical mask and were thoroughly trained for respiratory etiquette in our hospital. Moreover, given that no serious nosocomial outbreaks occurred during the study period, pre-hospitalization screening systems for contagious diseases could be a viable strategy for preventing nosocomial infections (15, 16) .