Nair R, Perencevich EN, Goto M, Livorsi DJ, Balkenende E, Kiscaden E, Schweizer ML. Patient care experience with utilization of isolation precautions: systematic literature review and meta-analysis.
Clin Microbiol Infect 2020;
26:684-695. [PMID:
32006691 DOI:
10.1016/j.cmi.2020.01.022]
[Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 12/16/2019] [Accepted: 01/18/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND
Use of isolation precautions (IP) may represent a trade-off between reduced transmission of infectious pathogens and reduced patient satisfaction with their care.
OBJECTIVE
To perform a systematic literature review and meta-analysis to identify if and how IPs impact patients' care experiences.
DATA SOURCES
Medline, ClinicalTrials.gov, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, PsychInfo, HSRProj and Cochrane Library databases.
STUDY ELIGIBILITY CRITERIA
Interventional and observational studies published January 1990 to May 2019 were eligible for inclusion.
PARTICIPANTS
Patients admitted to an acute-care facility.
INTERVENTIONS
IPs versus no IPs.
METHODS
Six reviewers screened titles, abstracts and full text. Experience of care reported by patients using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was assessed as the outcome for the meta-analysis. Pooled odds ratios were calculated using the random-effects model. Heterogeneity was assessed using the I2 value.
RESULTS
After screening 7073 titles and abstracts, 15 independent studies were included in the review. Pooling of unadjusted estimates from the HCAHPS survey demonstrated that IP patients were less likely to give top scores on questions pertaining to respect, communication, receiving assistance and cleanliness compared to the no-IP patients. Patients under IP with longer length of stay appeared to have more negative experiences with the care received during their stay compared to no IP.
CONCLUSIONS
Patients under IP were more likely to be dissatisfied with several aspects of patient care compared to patients not under IP. It is crucial to educate patients and healthcare workers in order to balance successful implementation of IP and patient care experiences, particularly in healthcare settings where it may be beneficial.
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