COVE R S TORY
Transforming patient isolation capacities
Patient isolation is essential to control outbreaks and prevent further infection. But as demand grows, how can our healthcare system keep up?
Northamptonshire, England, 1991.1 An outbreak of methicillin-resistant Staphylococcus aureus (MRSA) caused by a new strain has infected over 400 patients across 3 hospitals, 7 are dead. Failure to rapidly respond has inflated infection incidence and consequently the strain has spread. By 1992 neighbouring hospitals detect the strain, by 1993 the whole of the Southeast of England is affected. Patient isolation was key to the eventual containment of the outbreak. Healthcare- associated infections (HCAIs) are a modern- day reality that affect thousands annually. However, the current reality is that our NHS cannot house enough single occupancy isolation rooms to prevent transmission of potential new outbreaks.
Finding space for single occupancy In the UK, it’s common for hospital space to comprise of wards that host up to 8 patients. As little as 11.5% of bed stock is made up of single occupancy rooms. Patient isolation is limited by infrastructure. Although we could convert existing ward spaces to single occupancy, it’s expensive, disruptive and reduces overall capacity. Breaking down a multi-occupancy ward imposes a variety of hazards, and a 6-bed ward would typically convert to 3 individual rooms. Reducing permanent capacity to facilitate isolation is counter intuitive. The NHS has no interest in reducing the number of in- patients it can treat within its budget and space limitations. However, if we don’t do everything we can to stop the spread of HCAIs, our NHS will face the cost for longer hospital stays, continued care and poor patient outcomes.
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WWW.CLINICALSERVICESJOURNAL.COM Can we do it for less?
HCAIs are estimated to cost the NHS £2.7 billion per year.2
The National Institute for
Health and Care Excellence (NICE) estimates that 6.4% of patients who enter a hospital acquire an infection that they didn’t have when they entered hospital.3
This statistic
was quoted in the House of Commons as MPs took to parliament to debate ‘Raising the standards of infection prevention and control in the NHS’.4 For the budget holders, value for money is paramount to the implementation of interventions. “Value for money in healthcare is a very important theme. Anybody leading healthcare should be aware of the principle of good value for money or good return on investment,” says Professor Nicholas Graves, Professor of Health Economics at Duke- NUS Medical School. Providing or securing adequate isolation facilities is a critical infection prevention strategy that all healthcare providers must deliver. So, if we can’t rely on our current set up, we have to have a look at different ways we can approach patient isolation.
Employing a new perspective A more flexible alternative to putting up walls comes in the form of portable isolation units. The idea being that a tent-like structure can be opened around infected patients to prevent the spread of infection. This way, a 6-bed ward could remain a 6-bed ward, even if its hosting 6 isolating individuals. As part of an 8-year collaboration between clinicians, industrial designers and infection prevention experts, GAMA Healthcare are the first to introduce a product which delivers on the ideology of a portable isolation unit. Rediroom, GAMA’s solution to
Compassion and IPC:
time for a hard reset? Tackling environmental transmission of HCAIs Rapid detection of infection
W W W. C L I N I C A LS E R VI C E S JO U R N A L . C O M
instant isolation, was designed to embody multinational infection prevention guidelines.5
Rediroom: the world’s first mobile isolation room Rediroom is a fully functional instant isolation solution which is fully operational in less than 5 minutes.6
Stored as a cart,
it can be transformed by one person into a sealed isolation room suitable for droplet and contact precautions.
Implementing a physical barrier between patients is a safe way to reduce infections caused by droplets and contact. Plus, the infectious air within Rediroom exits via a HEPA14 filter which captures 99.995% of particles as small as 0.3µm – small enough to catch droplets before they reach another patient.
Patient isolation in practice Isolation capacities became stretched in response to the COVID-19 pandemic. Not only were patients isolated because of what we now see as ‘traditional’ causes of HCAIs (Clostridium difficile, norovirus, carbapenem- resistant Gram-negative bacteria and MRSA) but with SARS-CoV-2 also.
Throughout the duration of the pandemic, healthcare workers have been routinely subjected to frustration and fear caused by insufficient single-occupancy isolation areas.
DECEMBER 2021 DECEMBER 2021 THE CLINICAL SERVICES JOURNAL
INFECTION PREVENTION
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