[Utilization of patient isolation in non critical units from a university hospital]. / Utilización del aislamiento infeccioso en pacientes no críticos de un hospital universitario.

BACKGROUND AND OBJECTIVE: Correct utilization of source isolation (SI) in hospitals is important to take advantage of hospital resources. The objective of this work was to evaluate the utilization of SI considering the appropriateness of isolation length-stay. PATIENTS AND METHOD: During a period of 19 months a prospective observational study was carried out among non-critical inpatients who underwent SI in a university hospital. The information was obtained from Admission Unit data, daily ward rounds and review of case history records. RESULTS: A total of 239 SIs were identified, summarizing 2,589 days in isolation (median: 8 days, range: 1-56 days). These data supposed a cumulative incidence of 6.74 isolations by 1,000 admissions, and an incidence density of 1.08 isolations by 1,000 inpatient-day. 36.8% of SIs were considered incorrectly used, meaning a total of 703 inappropriate stays in isolation (27.1% of all stays carried out in SI). Surgical wound infections prompted inappropriate isolations with a greater frequency (45.2%), mainly after hip and knee prosthesis implantation interventions (42.9% and 17.9%, respectively). CONCLUSIONS: It is necessary to develop quality criteria and indicators in order to implement quality improvement actions to optimize SI length-stay management.

Utilización del aislamiento infeccioso en pacientes no críticos de un hospital universitario / Utilization of patient isolation in non critical units from a university hospital

Fundamento y objetivo: La correcta utilización del aislamiento infeccioso (AI) en los hospitales es importante para el adecuado aprovechamiento de los recursos hospitalarios, así como para el bienestar del paciente aislado. El objetivo de este trabajo es evaluar la utilización del AI medido a través de la adecuación de estancias. Pacientes y método: Durante un período de 19 meses se realizó un estudio prospectivo observacional de los AI indicados a pacientes no críticos de un hospital universitario de la Comunidad Valenciana. La información se obtuvo a partir de los datos de la unidad de admisión, la visita diaria a las salas de hospitalización y la consulta de las historias clínicas. Resultados: Se indicó un total de 239 AI que sumaron 2.589 estancias en AI (mediana de 8 días; extremos: 1-56 días). La incidencia acumulada en el período de estudio fue de 6,74 AI por cada 1.000 ingresos y la densidad de incidencia, de 1,08 AI por paciente-día. El 36,8% de los AI indicados se consideraron incorrectos, lo que se tradujo en 703 estancias en AI inadecuadas, es decir, un 27,1% del total de estancias realizadas en AI. Las infecciones de herida quirúrgica motivaron la inadecuación de los AI con mayor frecuencia (45,2%), sobre todo tras intervenciones de inserción de prótesis de cadera y rodilla (el 42,9 y el 17,9%, respectivamente). Conclusiones: Es necesario elaborar criterios e indicadores de calidad para implementar acciones de mejora continua que permitan optimizar la gestión de las estancias realizadas en AI

Background and objective: Correct utilization of source isolation (SI) in hospitals is important to take advantage of hospital resources. The objective of this work was to evaluate the utilization of SI considering the appropriateness of isolation length-stay. Patients and method: During a period of 19 months a prospective observational study was carried out among non-critical inpatients who underwent SI in a university hospital. The information was obtained from Admission Unit data, daily ward rounds and review of case history records. Results: A total of 239 SIs were identified, summarizing 2,589 days in isolation (median: 8 days, range: 1-56 days). These data supposed a cumulative incidence of 6.74 isolations by 1,000 admissions, and an incidence density of 1.08 isolations by 1,000 inpatient-day. 36.8% of SIs were considered incorrectly used, meaning a total of 703 inappropriate stays in isolation (27.1% of all stays carried out in SI). Surgical wound infections prompted inappropriate isolations with a greater frequency (45.2%), mainly after hip and knee prosthesis implantation interventions (42.9% and 17.9%, respectively). Conclusions: It is necessary to develop quality criteria and indicators in order to implement quality improvement actions to optimize SI length-stay management