But I had no idea the patient required isolation precautions!

Abstract

ISSUE: In December 2003, the infection control practitioners (ICPs) conducted isolation precaution compliance rounds to ensure that patients who required contact, droplet, and/or airborne precautions were promptly placed on precautions. We noted that in December 2003, 53% of patients who required isolation precautions (IP) were not placed on precautions. Initially, if a patient required IP, the ICPs would discuss the issue with the patient's nurse. This was time-consuming and did not ensure that IP were implemented or that areas receiving the patient were informed of the IP. A more efficient and successful method for implementing IP was needed. PROJECT: The ICPs determined that the main issue hindering implementation of IP was that per policy, a doctor's order was required to initiate IP. Two initiatives were trialed and implemented. The policy was revised to state that any patient caregiver could initiate IP. The ICPs would place a sticker on the front (sticker dimensions 4″ × 2⅝″) and side (1¼″ × 5/16″) of the patient's chart indicating that IP was required and would write a note in the interdisciplinary notes of the chart indicating the reason for precautions and the type required. RESULTS: This initiative has improved timeliness of implementation of IP, notification of receiving areas, and staff knowledge of when IP are required. Since implementing this initiative facilitywide in October 2004, there were 106 (15%) instances when IP were indicated that they were not implemented compared to 35%-50% before revision of the policy and use of the stickers. Precautions are now implemented within 1-2 days of receipt of test results. The ICPs can educate staff about IP while on the units rather than spending costly time attempting to find the correct person to talk to about the need for precautions. Receiving areas now know immediately if a patient is on IP instead of after the fact. LESSONS LEARNED: Some staff members rely on the chart being flagged, at times assuming that if a chart is not flagged, the patient must not need IP. The ICPs cannot be the only group responsible for flagging charts as they are not typically at the hospital during evenings and weekends or even every weekday. Staff response has been positive that the ICPs have assumed primary responsibility for initiating IP.