Comparing the impact of two contact isolation modes for hospitalised patients with Clostridioides difficile infection on the quality of care
© 2022 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd..
BACKGROUND: Clostridioides difficile causes healthcare-associated infections. Environmental spore acquisition is a major mode of transmission. Patient cohorting to prevent cross-transmission in healthcare-institutions is a reasonable component of an enhanced infection control strategy.
OBJECTIVE: The purpose of the study was to assess the effect of two different contact isolation modes on the quality of care of hospitalised patients with Clostridioides difficile infection (CDI).
METHODS: A retrospective cohort-study of patients with CDI hospitalised under one of two contact isolation modes: contact isolation in a multi-patient room without a dedicated nursing team vs. contact isolation in a permanent cohort isolation unit with a dedicated nursing team. Patients' files were reviewed for demographics, clinical characteristics, risk-assessment scores, clinical quality measures including the number of blood tests collected per day, the number of radiological tests applied per day and the time at which a radiological test was conducted, as process measurements, along with the length of stay and mortality, as outcome measures. The STROBE checklist for reporting observational studies was followed.
RESULTS: One hundred and seventy-eight patients with CDI were included; 100 in a permanent cohort isolation unit and 78 under contact isolation in a multi-patient room. No difference was found in all clinical quality process measures and in all outcome measures. Multivariable logistic regression showed that nursing home residence was associated with in-hospital mortality (OR, 2.51; CI, 1.29-4.97; p = .007), whereas the mode of hospitalisation was not.
CONCLUSIONS: The different contact isolation modes of hospitalisation did not compromise the quality of care of patients with CDI.
RELEVANCE TO CLINICAL PRACTICE: Cohorting of patients with CDI is used to prevent cross-transmission, though it raises a major concern regarding quality of care. In this study we show there was no compromise in patient care, therefore it is a reasonable component of an enhanced infection control strategy in a hospital setting.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:32 |
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| Enthalten in: |
Journal of clinical nursing - 32(2023), 5-6 vom: 07. März, Seite 872-878 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gehasi, Inbar [VerfasserIn] |
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| Links: |
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| Themen: |
Clostridioides difficile |
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| Anmerkungen: |
Date Completed 08.02.2023 Date Revised 12.04.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/jocn.16416 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM342827324 |
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| 500 | |a Date Revised 12.04.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND: Clostridioides difficile causes healthcare-associated infections. Environmental spore acquisition is a major mode of transmission. Patient cohorting to prevent cross-transmission in healthcare-institutions is a reasonable component of an enhanced infection control strategy | ||
| 520 | |a OBJECTIVE: The purpose of the study was to assess the effect of two different contact isolation modes on the quality of care of hospitalised patients with Clostridioides difficile infection (CDI) | ||
| 520 | |a METHODS: A retrospective cohort-study of patients with CDI hospitalised under one of two contact isolation modes: contact isolation in a multi-patient room without a dedicated nursing team vs. contact isolation in a permanent cohort isolation unit with a dedicated nursing team. Patients' files were reviewed for demographics, clinical characteristics, risk-assessment scores, clinical quality measures including the number of blood tests collected per day, the number of radiological tests applied per day and the time at which a radiological test was conducted, as process measurements, along with the length of stay and mortality, as outcome measures. The STROBE checklist for reporting observational studies was followed | ||
| 520 | |a RESULTS: One hundred and seventy-eight patients with CDI were included; 100 in a permanent cohort isolation unit and 78 under contact isolation in a multi-patient room. No difference was found in all clinical quality process measures and in all outcome measures. Multivariable logistic regression showed that nursing home residence was associated with in-hospital mortality (OR, 2.51; CI, 1.29-4.97; p = .007), whereas the mode of hospitalisation was not | ||
| 520 | |a CONCLUSIONS: The different contact isolation modes of hospitalisation did not compromise the quality of care of patients with CDI | ||
| 520 | |a RELEVANCE TO CLINICAL PRACTICE: Cohorting of patients with CDI is used to prevent cross-transmission, though it raises a major concern regarding quality of care. In this study we show there was no compromise in patient care, therefore it is a reasonable component of an enhanced infection control strategy in a hospital setting | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Clostridioides difficile | |
| 650 | 4 | |a cohort | |
| 650 | 4 | |a contact isolation | |
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| 650 | 4 | |a infection | |
| 650 | 4 | |a quality of care | |
| 700 | 1 | |a Livshiz-Riven, Ilana |e verfasserin |4 aut | |
| 700 | 1 | |a Michael, Tal |e verfasserin |4 aut | |
| 700 | 1 | |a Borer, Abraham |e verfasserin |4 aut | |
| 700 | 1 | |a Saidel-Odes, Lisa |e verfasserin |4 aut | |
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