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

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.

Isolation measures are important in the prevention of healthcare-associated infections. The terms used to describe categories of isolation have changed in response to new pathogens and with advances in infection prevention.

For 3 months in 2009, 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.

Three hundred and seventeen nurses gave responses to 2215 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 < 0.001). 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%).

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.