PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 3883854

Isolation practices: a historical perspective.

M M Jackson·P Lynch
View original source ↗Export metadata ↓

Abstract

Isolation practices assume a major role in the activities of many hospital infection prevention and control programs, yet few of the practices have been studied for efficacy. The origins for some of these practices can be traced to the nursing literature published in the American Journal of Nursing in the early part of the century. Others originated with public health measures for quarantine of communicable diseases in the community or attempts to simulate operating room practices for compromised patients. This historical review presents information about isolation practices from the perspective of the American Journal of Nursing with additional information from some Centers for Disease Control and American Hospital Association publications. The American Journal of Nursing was selected because it is a major source for content of nursing textbooks from which most nurses first learn isolation practices. Nurses are also the persons primarily responsible for the implementation of isolation practices in hospitals. Two themes emerged from this historical review: (1) a continuing debate about the importance of the inanimate environment and the importance of the airborne route versus the importance of contact with moist body substances as major modes of transmission of infectious agents and (2) a continuing debate between those who believe in special isolation techniques only for persons with diagnosed infections and those who believe all persons may harbor potentially infectious agents and who therefore focus attention on assessment of care requirements where contact with body substances is anticipated. This review is intended to encourage critical evaluation of isolation practices in use in hospitals today.

Explore related subjects

Cross InfectionHistory of NursingHistory, 19th CenturyHistory, 20th CenturyHospitalsHumansPatient IsolationProtective ClothingUnited KingdomUnited StatesHistorical ArticleJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

M M Jackson, P Lynch. 1985. Isolation practices: a historical perspective.. https://doi.org/10.1016/0196-6553(85)90005-7

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2005

Use of disposable prism tonometry in routine clinical practice.

AIM: To establish the reliability, efficacy, and safety of disposable prism tonometry and validate its routine use for screening as well as monitoring of glaucoma. METHODOLOGY: Intraocular pressure (IOP) of 400 eyes of 200 consecutive patients who attended the general ophthalmic clinic was checked with both the Goldmann applanation tonometer and a disposable tonometer prism by an experienced examiner after obtaining informed consent. The data were statistically analysed. RESULTS: The mean difference in the IOP between the two types of prisms was 0.1 mmHg (SD+/-1 mmHg). CONCLUSION: Disposable prism tonometry provides a reliable, effective, and safe alternative to Goldmann reusable prism tonometry for routine screening as well as monitoring of glaucoma with the advantages of eliminating the need for chemical disinfection and therefore eliminating the risk of crossinfection.

Cross Infection↗
PubMed2004

Isolation measures in the hospital management of methicillin resistant Staphylococcus aureus (MRSA): systematic review of the literature.

OBJECTIVE: To evaluate the evidence for the effectiveness of isolation measures in reducing the incidence of methicillin resistant Staphylococcus aureus (MRSA) colonisation and infection in hospital inpatients. DESIGN: Systematic review of published articles. DATA SOURCES: Medline, Embase, CINAHL, Cochrane Library, System for Information on Grey Literature in Europe (SIGLE), and citation lists (1966-2000). REVIEW METHODS: Articles reporting MRSA related outcomes and describing an isolation policy were selected. No quality restrictions were imposed on studies using isolation wards or nurse cohorting. Other studies were included if they were prospective or employed planned comparisons of retrospective data. RESULTS: 46 studies were accepted; 18 used isolation wards, nine used nurse cohorting, and 19 used other isolation policies. Most were interrupted time series, with few planned formal prospective studies. All but one reported multiple interventions. Consideration of potential confounders, measures to prevent bias, and appropriate statistical analysis were mostly lacking. No conclusions could be drawn in a third of studies. Most others provided evidence consistent with a reduction of MRSA acquisition. Six long interrupted time series provided the strongest evidence. Four of these provided evidence that intensive control measures including patient isolation were effective in controlling MRSA. In two others, isolation wards failed to prevent endemic MRSA. CONCLUSION: Major methodological weaknesses and inadequate reporting in published research mean that many plausible alternative explanations for reductions in MRSA acquisition associated with interventions cannot be excluded. No well designed studies exist that allow the role of isolation measures alone to be assessed. None the less, there is evidence that concerted efforts that include isolation can reduce MRSA even in endemic settings. Current isolation measures recommended in national guidelines should continue to be applied until further research establishes otherwise.

Cross Infection↗
PubMed2004

Golden rules.

Explore the source record for details and available documents.

Cross Infection↗