Care of children isolated for infection control: a prospective observational cohort study.
BACKGROUND
Patients with community-acquired or nosocomial infections are often managed in a hospital with isolation precautions. Given the high prevalence and substantial inconvenience associated with implementation of isolation precautions in pediatric settings, we explored the impact of this intervention on the care provided to children and their families.


OBJECTIVE
The purpose of this work was to compare the quantity and quality of care received by isolated patients relative to nonisolated patients.


METHODS
Sixty-five consecutive newly admitted inpatients in private rooms (24 isolated, 41 nonisolated) were recruited from the general pediatric service at the Hospital for Sick Children. Interactions between a medical team with patients and their families were observed. All of the participants were blinded to the study objectives. The medical team was observed during its morning rounds, and data were collected on the quantity and quality of care. Quantity of care was determined by the amount of time that the medical team spent interacting with the patient and parents and the number of organ systems examined by the attending physician during morning rounds. Quality of care was determined by using parental completion of the Pediatric Family Satisfaction Questionnaire.


RESULTS
We found no significant difference in the average amount of time spent interacting with isolated compared with nonisolated patients (516 vs 480 seconds) or the number of organ systems examined in isolated compared with nonisolated patients (3 vs 4). Isolated and nonisolated groups gave high ratings to all of the items pertaining to the facility, doctors, and nurses.


CONCLUSIONS
No large differences in quality or quantity of care were observed between isolated and nonisolated patients in the first 2 days of admission to a pediatric ward.
Cohen
Eyal
E
Department of Pediatrics, University of Toronto, Ontario, Canada. eyal.cohen@sickkids.ca
Austin
Janice
J
Weinstein
Michael
M
Matlow
Anne
A
Redelmeier
Donald A
DA
D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000628:therapy; D016001:Confidence Intervals; D003428:Cross Infection / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006776:Hospitals, Pediatric; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D009864:Ontario; D017063:Outcome Assessment, Health Care; D005791:Patient Care / Q000592:standards* / Q000639:trends; D010356:Patient Isolation; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D018709:Statistics, Nonparametric