Isolated patients get lower quality of care, say researchers

Hospital patients isolated for infection control experience more preventable adverse incidents and report greater dissatisfaction with their treatment, says a new study by University of Toronto and Harvard University researchers.

“Isolated patients were twice as likely as control patients to experience adverse events during their hospitalization,” says Professor Donald Redelmeier of U of T’s Department of Medicine. “Our most significant finding showed that they did not receive adequate supportive care – they were not given medication or food on time and their call buttons were not responded to promptly. These supportive care failures occurred about eight times more frequently for isolated patients than for the control group.”

The study, published in the Oct. 8 issue of the Journal of the American Medical Association, examined the experiences of 450 adult patients – 234 at Sunnybrook and Women’s College Health Sciences Center in Toronto and 216 at Brigham and Women’s Hospital in Boston, Mass. Redelmeier conducted the study with Henry Stelfox and David Bates of Harvard.

Seventy-eight patients in Toronto and 72 in Boston were admitted to isolation for methicillin-resistant Staphylococcus aureus, a hospital-acquired infection causing pneumonia, wound infections and heart problems. The Canadian patients were isolated for an average of 31 days.

Isolation is a highly effective measure for infection control but hospitals need to be aware of its drawbacks, Redelmeier says. He suggests three ways to alleviate problems: isolated patients should automatically be provided with a free phone and television to relieve boredom; clinicians need to be more responsive about who goes into isolation and for how long; and hospitals with large volumes of isolated patients should have a nurse dedicated to proactively check on their needs.

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CONTACT: Professor Donald Redelmeier, Department of Medicine, 416-480-6999, dar@ices.on.ca or Janet Wong, U of T public affairs, 416-978-5949, jf.wong@utoronto.ca