Comparing the impact of two contact isolation modes for hospitalised patients with Clostridioides difficile infection on the quality of care

Inbar Gehasi, Ilana Livshiz-Riven, Tal Michael, Abraham Borer, Lisa Saidel-Odes

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Number of pages7
JournalJournal of Clinical Nursing
DOIs
StatePublished - 27 Jun 2022

Keywords

  • Clostridioides difficile
  • cohort
  • contact isolation
  • hospitalised patients
  • infection
  • quality of care

ASJC Scopus subject areas

  • Nursing (all)

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