Impact of isolation on hospitalised patients who are infectious: systematic review with meta-analysis

Purssell, Edward; Gould, Dinah; Chudleigh, Jane

However, again there was wide variation between studies. Data on these outcomes are given in Figures 3 and 4 , and the non-clinically significant risks in the supplementary information ( Figure 5 ). 1000 patient-days (p<0.0001). [38] Other studies found that staff spent less time with those on contact precautions: internal medicine interns spent less time with their isolated patients compared to non-isolated patients, the median times being 5.2 and 6.9 minutes respectively (p<0.001) [37] ; while the mean number of contacts per hour with healthcare workers was 2.1 compared to 4.2 in those not isolated (p=0.03), although the duration was longer at 4.5 minutes compared to 2.8 (p=0.6). [39] Discussion Current recommendations say that contact precautions should include a single room, with personal protective equipment consisting of a gown and gloves for all patient contacts or contacts with potentially contaminated environmental areas. [1] This review has shown that there are a number of apparently negative aspects to contact Although at times there are discussions as to the necessity of contact precautions for drug resistant organisms, with some arguing that that there is mixed evidence for or against their use [46] another recent review has concluded that they are of great importance in the control of epidemic and endemic multidrug-resistant microorganisms. [47] The ethics of using contact precautions and other forms of isolation rely on a positive assessment of the balance between the risks and benefits of this to the individual concerned and that of the broader population of patients and staff. [48] However, even when this assessment is positive, it is important to ensure that any harm to the individual is minimised.