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Isolating infectious patients: organisational, clinical and ethical issues

Gould, D. J., Drey, N. ORCID: 0000-0003-0752-9049, Chudleigh, J. H. ORCID: 0000-0002-7334-8708, King, M-F., Wigglesworth, N. and Purssell, E. (2018). Isolating infectious patients: organisational, clinical and ethical issues. American Journal of Infection Control, doi: 10.1016/j.ajic.2018.05.024

Abstract

Background: Isolating infectious patients is essential to reduce infection risk. Effectiveness depends on identifying them, transfer to suitable accommodation and maintaining precautions.

Methods: Online study to address identification of infectious patients, transfer and challenges maintaining isolation in hospitals in the United Kingdom.

Results: Forty nine responses were obtained. Decision to isolate is taken between infection prevention teams, clinicians and managers. Respondents reported situations where isolation was impossible because of the patient’s physical condition or cognitive status. Very sick patients and those with dementia were not thought to tolerate isolation well. Patients were informed about need for isolation by ward nurses, sometimes with explanation from infection prevention teams. Explanations were often poorly received and comprehended, fuelling complaints. Respondents were aware of ethical dilemmas associated with isolation undertaken in the interests of other health service users and society. Organisational failures could delay in stigating isolation. Records were kept of demand for isolation and/or uptake but quality was variable.

Conclusion: Isolation has received greatest attention in countries with under - provision of accommodation. Our study demonstrates reasons for delays ide ntifying patients and isolation failure placing others at risk that apply in any organisation regardless of availability and highlights ethical dilemmas of enforcing isolation.

Publication Type: Article
Additional Information: © Elsevier 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Publisher Keywords: Isolation, Infection, Infectious patients, Ethics
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RT Nursing
Departments: School of Health Sciences > Nursing
URI: http://openaccess.city.ac.uk/id/eprint/19941
[img] Text - Accepted Version
This document is not freely accessible until 27 June 2019 due to copyright restrictions.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

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