Impact of admission to high-risk isolation room on patients’ and healthcare workers’ perceptions: A qualitative cross-assessment Approach

• Published in: Infectious diseases now (Online) Vol. 51; no. 3; pp. 247 - 252
• Main Authors: Bendjelloul, G., Gerard, S., Birgand, G., Lenne, F., Rioux, C., Lescure, X., Yazdanpanah, Y., Lucet, J.-C.
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.05.2021
• Subjects: Adult; Aged; Aged, 80 and over; Anxiety - epidemiology; Communicable disease control/standard; Cross Infection - prevention & control; Depressive disorder; France; Health Personnel - psychology; Hospital Design and Construction; Hospital design and construction/standard; Human; Humans; Infection Control - methods; Interviews as Topic; Middle Aged; Nursing staff, hospital/psychology; Original; Paris; Patient Isolation - psychology; Patient Safety; Patient Satisfaction; Perception; Qualitative Research; Quality of Health Care; Paris; Human; Communicable disease control/standard; Patient isolation/psychology; Hospital design and construction/standard; Nursing staff, hospital/psychology; France; Depressive disorder
• ISSN: 2666-9919; 0399-077X; 2666-9919; 1769-6690
• DOI: 10.1016/j.medmal.2020.10.020

•The consequences of hospital admission of high-risk infectious patients into special rooms have been only rarely investigated.•Our work is based on semi-structured interviews of 14 patients and 16 Health Care Workers and shows that patients housed with specific precautions have a negative representation of these spaces and a feeling of confinement as opposed to those admitted without precautions.•Health Care Workers also have a negative view of these rooms. High-risk isolation units (HRIU) house patients at high risk of transmitting infectious agents, notably patients with suspected viral hemorrhagic fever or smear-positive tuberculosis. Admission to HRIU can alter the quality of care and impact patients’ and healthcare workers’ (HCWs) anxiety and dissatisfaction. The Infectious Diseases Department of the Bichat Claude Bernard Hospital in Paris houses a 7–bed HRIU. We conducted a qualitative study based on individual semi-structured interviews to assess the perceptions of both patients and HCWs. We interviewed 14 patients and 16 HCWs routinely working in the HRIU. All 8 patients subject to isolation precautions and 1 of the 6 patients not subject to isolation precautions expressed a negative representation of the room with a feeling of confinement, stigma, and mistrust. They also reported a lack of information from healthcare staff and a need for entertainment, activities, and visits from relatives. HCWs did not like working in this unit because of the anteroom's technical constraints and a loss of frequent contact with patients. They also expressed a feeling of insecurity working in these units despite the use of interphones. Placing patients in an HRIU not only affects their emotions, but also impacts HCWs both emotionally and organizationally. Alert systems, intercoms, and videoconferencing systems can improve safety and security as well as exchanges with patients and their relatives. Psychological support is needed for patients who are subject to isolation precautions and for their attending HCWs.