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| 2007 Patient Isolation Policy (60 kB) |
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Page updated 30 April 2007
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Know the types of patient isolation: |
In order to prevent the spread of micro-organisms, it is often necessary to isolate patients.
There are two types of isolation:
Source Isolation aims to confine the infectious agent and prevent its spread.
Protective Isolation aims to protect an immunocompromised patient who is at special risk from environmental organisms or those carried by attending staff and visitors.
The decision to isolate a patient is taken by the medical team caring for the patient, in consultation with the nursing staff and Infection Control Team. Isolation is usually carried out in single rooms with hand washing facilities and with the door closed. Occasionally, a group of patients with a particular infection may be cohort nursed together in a defined ward area. A patient or groups of patients (a cohort) can be successfully barrier nursed in a ward, but this should only be done as a last resort.
It is the responsibility of ALL members of staff to comply with Isolation and Infection Control procedures. Remember that nosocomial infections are generally transmitted by health care workers. One failure to comply with simple procedures may negate the diligence of the rest of the team.
Patients with certain illnesses should be isolated immediately when facilities are available, for example:
Occasionally a staff member may be found to be an asymptomatic carrier of a potentially pathogenic organism and may be considered to be a potential source of infection. In these cases it may be necessary to treat staff in order to eradicate carriage of the organism, using a systemic antibiotic (e.g. for Group A Streptococcus pyogenes) or by topical preparations (e.g. for methicillin-resistant Staphylococcus aureus). An infectious staff carrier of a blood-borne virus such as HIV or HBV will not be allowed to perform invasive (“exposure prone”) procedures.
A basic understanding of the way in which particular organisms are spread will enable staff to apply a common sense approach to isolation, thus providing a safe environment and avoiding unnecessary psychological trauma to patients and relatives.
Information and detailed protocols on various specific diseases are given in the tables and protocols in specific Communicable Diseases.
People who have infections or who are infectious to others often feel "unclean" or "dirty". There are many myths about how infections are spread and people are frequently stigmatised or shunned by society.
Patients who are nursed in isolation may feel this particularly acutely and may develop some of the adverse effects of isolation. These include a wide spectrum of psychological and emotional symptoms such as boredom, depression, tearfulness, restlessness, anger, fear, insecurity, anxiety, introspection, lethargy, mania, obsessive behaviour, paranoia, psychosis and "cabin fever".
A major part of our work is helping to anticipate and minimise these effects of isolation. It is important that we try to identify these ill effects early. This will benefit the patient and will also help compliance with isolation procedures. Try to spend time with your patients rather than simply going in to perform "tasks", encourage them to have their own belongings around them, make sure they have a working television with a remote control and a radio and encourage visitors.
NHS Estates. HBN 4 Supplement 1: Isolation facilities in acute settings February 2005.
UK Department of Health. A Matron's Charter: an Action Plan for Cleaner Hospitals. 2004.
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