Hospital patient experiences of contact isolation for antimicrobial resistant organisms in relation to health care–associated infections: A systematic review and narrative synthesis of the evidence

Abstract

•Infection prevention and control is essential in clinical settings.•Health care–associated infections and antimicrobial resistance are a growing concern.•The contemporary context of isolation for infection prevention control is evolving.•Patient’s experience of contact isolation might be influenced by several factors.•Health care professionals must consider individual circumstances in delivery care. BackgroundThe alarming growth of antimicrobial resistance organisms (AMRs) and the threat caused by health care–associated infections require hospitalized individuals who are infected or colonized with AMRs to be cared for in isolation, predominantly in single rooms. None of the existing reviews focus on or specifically address the patient’s experience of being cared for in contact isolation when affected by AMRs exploring this specific context.MethodsPreferred Reporting Items for Systematic Reviews and Meta-Analyses guidance for the conduct of systematic reviews was applied. Five databases were searched from inception to April 2019, with keywords related to adult patient experiences, AMR, and contact isolation. The evidence was certified by 2 reviewers. Principles of thematic analysis were used to produce a narrative synthesis of the findings.ResultsEighteen eligible studies were identified. Narrative synthesis resulted in 3 overarching categories reflecting the patient experience: privacy versus loneliness; emotional responses to isolation; quality of care, recovery, and safety in isolation.ConclusionsThis review synthesizes existing evidence reflecting the patient experience of contact isolation. Study findings were often contradictory and may not reflect contemporary health care, such as shorter hospital stays, or societal preferences for greater privacy. Further research focusing on contemporary health care contexts is recommended. The alarming growth of antimicrobial resistance organisms (AMRs) and the threat caused by health care–associated infections require hospitalized individuals who are infected or colonized with AMRs to be cared for in isolation, predominantly in single rooms. None of the existing reviews focus on or specifically address the patient’s experience of being cared for in contact isolation when affected by AMRs exploring this specific context. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance for the conduct of systematic reviews was applied. Five databases were searched from inception to April 2019, with keywords related to adult patient experiences, AMR, and contact isolation. The evidence was certified by 2 reviewers. Principles of thematic analysis were used to produce a narrative synthesis of the findings. Eighteen eligible studies were identified. Narrative synthesis resulted in 3 overarching categories reflecting the patient experience: privacy versus loneliness; emotional responses to isolation; quality of care, recovery, and safety in isolation. This review synthesizes existing evidence reflecting the patient experience of contact isolation. Study findings were often contradictory and may not reflect contemporary health care, such as shorter hospital stays, or societal preferences for greater privacy. Further research focusing on contemporary health care contexts is recommended.

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