Accommodating patients with a history of colonisation or infection with a multi-resistant organism: a case study investigation

Abstract

Health care associated infection (HAI) with multi-resistant organisms is a major concern for in-patient facilities. Individuals who have previously been infected or colonised with multi-resistant organisms may require in-patient rehospitalisation, yet consistent application of infection control precautions remains problematic. This paper reports the findings of a case study that explored the application of contact precautions in a specific hospital context. Specifically, the factors that influence the accommodation of people, with a history of infection or colonisation with a multi-resistant organism, when they are admitted to hospital, are described. Data from semi-structured interviews were subject to a qualitative content analysis. The findings reveal complex interactions among health professional practices, material resources and organisational dynamics. Consequently, the responsibility for appropriately accommodating patients infected or colonised with multi-resistant organisms may be shouldered by many healthcare professionals but borne by none. The findings indicate that there is a need for creative solutions to the issues that impact on the application of infection control protocols in clinical environments. A strategic practice development framework is proposed to enact responsive, effective and accountable practice in the implementation of contact precautions.