Droplet precautions on site instead of single room isolation for respiratory tract infections

Sommerstein, Rami; Azevedo, Tiago Castro Lopes; Aerschmann, Christina; Hobi, Fabienne; Egger, Martin; Marschall, Jonas

doi:10.1017/ice.2019.142

Cited by 4 publications

(2 citation statements)

References 5 publications

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“…A similar approach was previously implemented for other viral respiratory infections and revealed similar results [ 9 , 10 ]: Birrer et al evaluated the introduction of on-site droplet precautions in a tertiary-care center during the 2018/19 influenza season and did not find an increased rate of nosocomial infections as compared with the standard single-room isolation strategy [ 9 ]. To our knowledge this is the first study reporting data on the safety and feasibility of this strategy in the setting of suspected COVID-19.…”

Section: Discussionmentioning

confidence: 82%

Secondary attack rate following on-site isolation of patients with suspected COVID-19 in multiple-bed rooms

Ragozzino,

Kuehl,

Leuzinger

et al. 2024

Antimicrob Resist Infect Control

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The implementation of isolation precautions for patients with suspected Coronavirus Disease 2019 (COVID-19) and pending test results is resource intensive. Due to the limited availability of single-bed rooms at our institution, we isolated patients with suspected COVID-19 together with patients without suspected COVID-19 on-site in multiple-bed rooms until SARS-CoV-2-test results were available. We evaluated the likelihood of SARS-CoV-2 transmission to individuals sharing the room with patients isolated on-site. This observational study was performed at the University Hospital Basel, Switzerland, from 03/20 − 11/20. Secondary attack rates were compared between patients hospitalized in multiple-bed rooms and exposed to individuals subjected to on-site isolation precautions (on-site isolation group), and patients exposed to individuals initially not identified as having COVID-19, and not placed under isolation precautions until the diagnosis was suspected (control group). Transmission events were confirmed by whole-genome sequencing. Among 1,218 patients with suspected COVID-19, 67 (5.5%) tested positive for SARS-CoV-2. Of these, 21 were isolated on-site potentially exposing 27 patients sharing the same room. Median contact time was 12 h (interquartile range 7–18 h). SARS-CoV-2 transmission was identified in none of the patients in the on-site isolation group vs. 10/63 (15.9%) in the control group (p = 0.03). Isolation on-site of suspected COVID-19-patients in multiple-bed rooms avoided single-room occupancy and subsequent in-hospital relocation for many patients without confirmed SARS-CoV-2-infection. The absence of secondary transmission among the exposed patients in the on-site isolation group allows for assessment of the risk/benefit ratio of this strategy given the limitation of a small sample size.

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Section: Discussionmentioning

confidence: 82%

Secondary attack rate following on-site isolation of patients with suspected COVID-19 in multiple-bed rooms

Ragozzino,

Kuehl,

Leuzinger

et al. 2024

Antimicrob Resist Infect Control

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“… 35–37 However, we are not aware that such educational programmes routinely address how negative psychological impacts of IP could be mitigated. Although concepts for accommodating colonised or infected patients in a multibed room instead of a single room have been evaluated, they focused on prevention of transmission 38 or feasibility and acceptance by healthcare workers 39 but did not examine the psychological impact on patients. Besides, a considerable proportion of isolated patients are not well informed about their reasons for isolation and its value for the community 14 : thus, better information may help to decrease the negative impact of IP.…”

Section: Discussionmentioning

confidence: 99%

Measuring perception of mental well-being in patients under isolation precautions: a prospective comparative study

et al. 2022

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ObjectivesIsolation precautions (IP) are applied to prevent transmission of pathogens in healthcare settings. Potential negative health outcomes experienced by patients have been previously described but results remain conflicting. We aimed at evaluating the psychological impact of IP in adult patients in isolation using a novel psychological assessment tool.Study designProspective matched cohort study.SettingTertiary care centre in Switzerland.ParticipantsHospitalised patients under IP and non-isolated patients were matched by ward, age and illness severity.Outcome measuresWe measured surrogates of mental and social well-being by using the Pictorial Representation of Illness and Self Measure (PRISM) instrument once during hospitalisation. PRISM is a visual psychometric instrument that has been validated as a quantitative measure of suffering. Smaller distance in self-to-illness separation (SIS) signifies higher importance for a patient.Results156 patients agreed to participate of which 63 were under IP and 93 were matched controls. Median (IQR) duration of isolation was 5 days (2–10). The median SIS (IQR) for perceived inferior nurses’ care was 22.8 (18.5–24.3) and 23.8 (23.3–25.5) for isolated and non-isolated patients, respectively (p<0.001). Similarly, median SIS (IQR) was significantly smaller in isolated than non-isolated patients for avoidance by visitors with 17.5 (7.7–22.0) and 22.2 (21.8–22.6), for loneliness with 7.5 (3.6–16.0) and 18 (10.2–21.6) and for feeling impure with 19 (17.0–21.5) and 21.5 (18.9–22.1), respectively (all p values<0.05).ConclusionsIP to prevent transmission of pathogens may negatively impact mental and social well-being. Measures to alleviate adverse effects of IP should be taken routinely.

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Hospital-acquired respiratory viral infections while applying droplet precautions on-site (DroPS) - prospective observation during the 2019/20 influenza season, Bern, Switzerland

Birrer,

Draps,

Hobi

et al. 2024

Infection Prevention in Practice

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Droplet precautions on site instead of single room isolation for respiratory tract infections

Cited by 4 publications

References 5 publications

Secondary attack rate following on-site isolation of patients with suspected COVID-19 in multiple-bed rooms

Secondary attack rate following on-site isolation of patients with suspected COVID-19 in multiple-bed rooms

Measuring perception of mental well-being in patients under isolation precautions: a prospective comparative study

Hospital-acquired respiratory viral infections while applying droplet precautions on-site (DroPS) - prospective observation during the 2019/20 influenza season, Bern, Switzerland

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