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The overuse of single patient isolation in hospitals
Abstract:
Single patient isolation of adults to prevent spread of infection was studied in five high occupancy community hospitals. The acceptable standard was a guideline for isolation in hospitals, published by the Center for Disease Control (CDC). Overusage of single patient isolation was found to vary between 4% and 96% of physician's isolation orders. Diagnoses of viral hepatitis, surgical wound infections, skin infections and respiratory infections accounted for the majority of overisolated patients. When infection control personnel rather than attending physicians determined the type and duration of isolation, a decrease in overisolation and a saving of patient (or third party payer) charges could be demonstrated. Reduction in overisolation does not bring about savings for hospitals unless bed occupancy is high and few single rooms are available. No evidence of cross-infection was observed in one hospital as a result of implementation of the CDC guidelines.
Insights
Overuse of single patient isolation in hospitals is common, especially for viral hepatitis and skin infections. Implementing infection control guidelines can reduce unnecessary isolation and save costs.
Area of Science:
- Infection Control
- Hospital Administration
- Public Health
Background:
- Single patient isolation is a key strategy to prevent healthcare-associated infections.
- The Center for Disease Control (CDC) provides guidelines for appropriate isolation practices.
- High occupancy in community hospitals may influence isolation practices.
Purpose of the Study:
- To assess the extent of overusage of single patient isolation in community hospitals.
- To evaluate the impact of infection control personnel-led isolation decisions on overusage and costs.
- To determine if adherence to CDC isolation guidelines affects cross-infection rates.
Main Methods:
- A study was conducted in five high-occupancy community hospitals.
- Physician orders for single patient isolation were analyzed.
- Isolation practices were compared between physician-led and infection control personnel-led decision-making.
- Patient charges and cross-infection rates were monitored.
Main Results:
- Overusage of single patient isolation varied significantly, from 4% to 96% of physician orders.
- Viral hepatitis, surgical wound infections, skin infections, and respiratory infections were common reasons for overisolation.
- Transferring isolation decisions to infection control personnel reduced overisolation and patient charges.
- Hospital savings were contingent on high bed occupancy and limited single room availability.
- No cross-infections were observed when CDC guidelines were followed.
Conclusions:
- Physician-driven isolation practices often lead to significant overusage.
- Infection control personnel can optimize isolation protocols, reducing costs and unnecessary patient isolation.
- Adherence to CDC guidelines is effective in preventing cross-infections and can lead to cost savings in specific hospital settings.