Adapting disease-specific isolation guidelines to a hospital information system

Area of Science:

• Hospital Informatics
• Infection Control
• Public Health

Background:

• Disease-specific isolation precautions are crucial for preventing healthcare-associated infections.
• Existing guidelines require effective translation into clinical practice for optimal patient safety.
• Computerized systems offer potential for standardizing and improving adherence to isolation protocols.

Purpose of the Study:

• To adapt the Centers for Disease Control's (CDC) isolation guidelines into a hospital computerized information system.
• To evaluate the impact of a computerized disease-specific isolation system on the appropriate use of isolation precautions.
• To identify factors influencing the successful implementation and effectiveness of the computerized system.

Main Methods:

• Modification of CDC isolation guidelines into a hospital computerized information system.
• System features included automated generation of instructions, supply orders, and patient charges.
• Pre- and post-implementation prevalence surveys were conducted to assess isolation order accuracy.
• In-service training for nurses and physician practice modification were integral to implementation.

Main Results:

• Initial implementation showed isolation ordered for only 21% of indicated patients, highlighting a significant problem.
• Post-implementation, following continuous surveillance and consultation, isolation orders increased to 81% when indicated.
• The computerized system, coupled with education and surveillance, led to more accurate and appropriate use of isolation.

Conclusions:

• A computerized disease-specific isolation system can significantly improve the accuracy and utilization of isolation precautions in hospitals.
• Effective implementation requires comprehensive in-service education and targeted efforts to modify physician ordering practices.
• Continuous surveillance and consultation are vital components for maximizing the benefits of such computerized systems in infection control.