Patient Isolation Is Associated To Delirium

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Patient isolation is one of the highly effective measures included in contact precautions. This is taken for the prevention of possible spread of difficult-to-treat infections like MRSA (Methicillin resistant staphylococcus aureus).  These measures include patient isolation, wearing of personal protective equipment (like gowns and masks). It was noted in a recent study that patients who are moved into isolation during their hospitalization are twice more vulnerable to experience delirium (a potentially risky change in mental status often affecting hospitalized patients).  However, no increased risk was observed in patients who were already isolated upon admission. This research can be found in the January issue of Infection Control and Hospital Epidemiology (journal of the Society for Healthcare Epidemiology of America).

Contact precautions presented a concern among some health team members, as these may cause disorientation and eventually delirium in patients. Delirium may have an adverse consequence pertaining to client care, even if it is only a temporary condition. Some of its symptoms are fluctuations in consciousness, confusion, and inattention.

Dr. Hannah Day of the University of Maryland School of Medicine and her team studied the two-year data from the university’s 662-bed medical center. They discovered that patients placed on patient isolation later in their hospital stay had 1.75 times increased likelihood of developing delirium. Nonetheless, those who were already placed on contact precautions upon admission were not observed to develop delirium. Moreover, the researchers believe that it may not be the isolation itself that leads to delirium, but the underlying illness. In addition, patients who were on contact precautions later after their admission became more ill, compared to those who were on such precautions from the start.

Moreover, according to Dr. Day, clinicians need to look into isolation as an indicator for greater risk of experiencing delirium, regardless of the cause. Also, they should employ necessary precautions to prevent it.

Furthermore, Dr. Day and her team emphasized that it is necessary to educate the patients placed on contact precautions regarding the reasons and purpose of the measure. In this way, they would feel more at ease with it. It is also important to place clocks, calendars and other items that can orient them constantly; this intervention can improve orientation and prevent sensory deprivation. Additionally, health team members should be responsible in monitoring patients’ medications which may contribute to this condition’s development and avoid disrupting the patients’ sleep patterns. Indeed, delirium is a preventable phenomenon, which makes the clinician’s role very crucial.

 

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