Simulations are of particular advantage in research studies where large samples are necessary to achieve statistical power and the information must be collected under uniform conditions in order to aid interpretation. In the study reported below, simulation was achieved through the use of medical photography accompanied by case studies of the same patients. All information was collected on the same day. The purpose of the study was to determine the validity of the three pressure ulcer risk assessment scales most commonly used in clinical nursing practice in the UK. Each clinical nurse assessed the same four patients using three risk assessment scales and a visual analogue scale designed to capture their own clinical judgement. External validity was assessed by a panel of tissue viability experts who provided independent ratings. Data were obtained from 236 clinical nurses, yielding 941 risk assessments. Experience with this approach to data collection suggests that it requires careful planning. This should include measures to ensure that the simulated information is valid and that all data collectors have been adequately trained and are able to motivate the nurses participating in the study. Providing consideration is given to these issues, the use of simulation can help to collect data that would be difficult to obtain by more conventional means. It is also important to recognize that clinical decisions are de-contextualized in simulations because they are reduced to verbal and visual summaries. The decision to use simulations should thus be taken only if this is acknowledged.

Compliance to infection control precautions is internationally suboptimal. The evidence confirms that compliance to specific aspects of standard/UPs varies, and practitioners are selective in their application of recommended practice. Compliance does improve following a structured intervention; however, research fails to indicate for how long the intervention affects practitioner compliance, or whether compliance after a period of time returns to the norm. Several reasons for non-compliance are discussed, and recommendations for future research are suggested. Relevance to clinical practice. Suboptimal compliance has significant implications for staff safety, patient protection and the care environment. Infection control teams and researchers need to consider the reasons for non-compliance and provide a supportive environment that is conducive to the routine, long-term application of standard precautions.

This quantitative research has attempted to investigate the psychological effects of hospitalisation and source isolation, and assessed whether were they influential in affecting a patient's cognitive coping with these two stressors. The research evaluated whether isolating a person because of an infection was a more stressful event (causing negative effects on four measured psychological constructs) than routine hospital admission. The research was conducted in two large District General Hospitals and one elderly care hospital. Individuals admitted to one of the research sites, and who satisfied the sample criteria, were adopted. The total number of subjects was 40. The research design was quasi experimental (post test only control group design), using a quantitative approach. Following a period of hospitalisation or isolation subjects in the control group (Group 1, hospitalised subjects n = 20) and subjects in the experimental group (Group 2, isolated subjects, n = 20) were given the following to complete: the Hospital Anxiety and Depression Scale, the Health Illness (Powerlessness) Questionnaire, and the Self Esteem Scale. These measured four psychological constructs: anxiety, depression, self esteem and sense of control. The quantitative data generated were analysed using descriptive statistics and the Student's t-test. The findings confirmed and validated previous research that hospitalisation results in many negative feelings that have detrimental effects on psychological well being and coping. However, more significantly, infected subjects who were isolated demonstrated feelings of anxiety, and depression that were significantly higher, and feelings of self esteem and sense of control that were significantly lower than those demonstrated by hospitalised subjects. Thus it could be argued that isolation has an even greater negative effect on their coping. Further research therefore needs to examine how specific nurse interventions can ameliorate the identified negative effects of isolation and so facilitate effective coping and positive psychological well being.

Multi-resistant bacteria pose an increasing and significant challenge to public health. Isolation precautions in patients with multi-drug-resistant bacteria and other communicable infectious agents can be associated with adverse effects. Although few would dispute the need for such practices in preventing the spread of transmissible infections, patients' perspectives of isolation suggest that the imposed environment creates barriers to their physical, social and emotional needs. This article reviews the literature to uncover any reliable evidence supporting the assertion that the experience of isolation in healthcare settings impacts adversely on patient wellbeing. Database searches identified 25 relevant papers published between 1990 and 2017. A number of studies claimed to have uncovered an association between negative patient experiences and isolation.