Patient care experience with utilization of isolation precautions: systematic literature review and meta-analysis

R Nair; E N Perencevich; M Goto; D J Livorsi; E Balkenende; E Kiscaden; M L Schweizer

doi:10.1016/j.cmi.2020.01.022

Patient care experience with utilization of isolation precautions: systematic literature review and meta-analysis

Clin Microbiol Infect. 2020 Jun;26(6):684-695. doi: 10.1016/j.cmi.2020.01.022. Epub 2020 Jan 30.

Authors

R Nair¹, E N Perencevich¹, M Goto¹, D J Livorsi¹, E Balkenende¹, E Kiscaden², M L Schweizer³

Affiliations

¹ Center for Access & Delivery Research & Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, USA; Department of Internal Medicine, University of Iowa Carver College of Medicine, USA.
² Hardin Library for Health Sciences, University of Iowa, Iowa City, IA, USA.
³ Center for Access & Delivery Research & Evaluation (CADRE), Iowa City Veterans Affairs Health Care System, USA; Department of Internal Medicine, University of Iowa Carver College of Medicine, USA. Electronic address: marin-schweizer@uiowa.edu.

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.

Keywords: Contact precautions; Infection control; Meta-analysis; Patient experience; Patient satisfaction.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Communicable Diseases / transmission
Health Personnel
Hospitalization*
Humans
Patient Care*
Patient Isolation / methods*
Patient Satisfaction / statistics & numerical data*

Abstract

Publication types

MeSH terms

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