Colonised and isolated: a qualitative metasynthesis of patients’ experiences of being infected with multiple drug resistant organisms and subsequent isolation
Gift Alexander Mutsonziwa A C and Jennifer Green B
+ Author Affiliations
- Author Affiliations
A 2 Solar Place, Glenwood, NSW 2768, Australia.
B Sydney Nursing School, The University of Sydney, Sydney, NSW 2006, Australia.
C Corresponding author. Email: giftmutsonziwa@yahoo.com
Healthcare Infection 16(4) 147-155 https://doi.org/10.1071/HI11020
Submitted: 17 July 2011 Accepted: 14 December 2011 Published: 16 January 2012
Abstract
Background: The rapid growth of antibiotic-resistant ‘super bugs’, as well as the evolution of new mutant viruses, has resulted in source isolation being a worldwide challenge. Being infected with multidrug resistant organisms (MDROs) and the consequent isolation can be an extremely distressing experience which warrants further investigation.
Aim: To identify, compare and synthesise studies on patients’ experiences of being infected with MDROs and subsequent isolation.
Design: Qualitative metasynthesis.
Procedure: Using a meta-ethnographic comparative method, nine qualitative studies were discovered on this topic, from which 43 themes and concepts were gathered. A closer examination yielded seven central themes which described the experiences of source isolation by 108 participants.
Findings: An interpretative analysis of this metasynthesis yielded some new understandings. These include the need for: promoting effective and adequate communication; incorporating patients’ views in policies; employing an interdisciplinary model of care; continuity of quality care; providing individualised care; and improving staff education and competencies.
Significances of this study: To recognise that although source isolation is a common practice in the clinical arena, patients often experience adverse effects. As the demand for accountability of the health workers to patients and the general public has increased, more responsive interventions must be developed.
References
[1] Denton PF. Psychological and physiological effects of isolation. Nursing 1986; 3 88–91.| 1:STN:280:DyaL283jtFOhsA%3D%3D&md5=62cc7a71717ab0227d088f9887ebba1dCAS |
[2] Abad C, Fearday A, Abdar N. Adverse effects of isolations in hospitalised patients: A systematic review. J Hosp Infect 2010; 76 97–102.
| Adverse effects of isolations in hospitalised patients: A systematic review.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3cfgtFSnsg%3D%3D&md5=61c22556f8d1a105103b473a0c6b5849CAS |
[3] Larson EL, Cohen B, Ross B, Behta M. Isolation precautions for Methicillin-resistant staphylococcus aureus: Electronic surveillance to monitor adherence. Am J Crit Care 2010; 19 16–26.
| Isolation precautions for Methicillin-resistant staphylococcus aureus: Electronic surveillance to monitor adherence.Crossref | GoogleScholarGoogle Scholar |
[4] Radmacher ED, Allen RB, House HY, eds. (2009) Nelson’s New King James Bible, (Leviticus 13:46–47) Thomas Nelson Publishers, Nashville.
[5] Gupta AR, Kaul NC, Saraswat V, Prabhakar T. A study of bacteriological profile in an ICU set up and effect of barrier nursing on the existing profile. Indian Journal of Anaesthesia 2005; 49 31–6.
[6] Gould D. Isolation precautions to prevent the spread of contagious diseases. Nursing Standard 2009; 23 47–55.
| 1:STN:280:DC%2BD1M7ovVOlsQ%3D%3D&md5=5ff9e7b449475022a687ab94d01ff44dCAS |
[7] Gammon J. The Psychological consequences of isolation: A review of literature. J Clin Nurs 1999; 8 13–21.
| The Psychological consequences of isolation: A review of literature.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M3jtVOrsg%3D%3D&md5=0f0aa186e3fc43e5863c0e2532cefb1aCAS |
[8] Zimmer L. Qualitative metasynthesis: A question of dialoguing with texts. J Adv Nurs 2006; 53 311–8.
| Qualitative metasynthesis: A question of dialoguing with texts.Crossref | GoogleScholarGoogle Scholar |
[9] Stern P, Harris C. Women’s health and the self-care paradox: A model to guide self-care readiness – clash between the client and nurse. Health Care Women Int 1985; 6 151–63.
| Women’s health and the self-care paradox: A model to guide self-care readiness – clash between the client and nurse.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL287htFeltg%3D%3D&md5=52eb02caf3c32b67d1159a0a1c4c5f89CAS |
[10] Sandelowski M, Docherty S, Emden C. Qualitative metasynthesis: Issues and techniques. Res Nurs Health 1997; 20 365–71.
| Qualitative metasynthesis: Issues and techniques.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2svgtFShtw%3D%3D&md5=32da041af409dd1700a0fcd5a1d4dde3CAS |
[11] Finlayson KW, Dixon A. Qualitative metasynthesis: A guide for the novice. Nurse Res 2008; 15 59–71.
[12] Noblit GW, Hare RD. (1988) Meta-ethnography: Synthesising qualitative studies. Beverly Hills, CA Sage.
[13] Meadows-Oliver M. Homeless adolescent Mothers: A metasynthesis of their life experiences. J Pediatr Nurs 2006; 21 340–9.
| Homeless adolescent Mothers: A metasynthesis of their life experiences.Crossref | GoogleScholarGoogle Scholar |
[14] Beck CT. Metasynthesis: A goldmine for evidence-based practice. AORN J 2009; 90 701–10.
| Metasynthesis: A goldmine for evidence-based practice.Crossref | GoogleScholarGoogle Scholar |
[15] Aagaard H, Hall EO. Mothers’ experiences of having a preterm infant in the Neonatal Care Unit: A metasynthesis. J Pediatr Nurs 2008; 23 e26–36.
| Mothers’ experiences of having a preterm infant in the Neonatal Care Unit: A metasynthesis.Crossref | GoogleScholarGoogle Scholar |
[16] Hildingh F, Fridlund B, Lidell E. Women’s experiences of recovery after myocardial infarction: A metasynthesis. Heart Lung 2007; 36 410–7.
| Women’s experiences of recovery after myocardial infarction: A metasynthesis.Crossref | GoogleScholarGoogle Scholar |
[17] Skyman E, Sjonstrom HT, Hellstom L. Patients’ experiences of being infected with MRSA at a hospital and subsequently source isolated. Scand J Caring Sci 2010; 24 101–7.
| Patients’ experiences of being infected with MRSA at a hospital and subsequently source isolated.Crossref | GoogleScholarGoogle Scholar |
[18] Burnett E, Lee K, Rushmer R, Ellis M, Noble N, Davey P. Health care associated infection and the patient experience: A qualitative study using patient interviews. J Hosp Infect 2010; 74 42–7.
| Health care associated infection and the patient experience: A qualitative study using patient interviews.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3c%2Fjs1yntA%3D%3D&md5=8407492581fecf032cf0db2f09eb0f37CAS |
[19] Lindberg M, Carlsson M, Hogman M, Skytt B. Suffering from methicillin-resistant Staphylococcus aureus: Experiences and understandings of colonisation. J Hosp Infect 2009; 73 271–7.
| Suffering from methicillin-resistant Staphylococcus aureus: Experiences and understandings of colonisation.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1Mnpsl2isw%3D%3D&md5=396ad4b591b8325a5118a7ab7a7e9ea9CAS |
[20] Criddle P, Potter J. Exploring patients’ views on colonisation with methicillin-resistant Staphylococcus aureus. British Journal of Infection Control 2006; 7 24–8.
| Exploring patients’ views on colonisation with methicillin-resistant Staphylococcus aureus.Crossref | GoogleScholarGoogle Scholar |
[21] Newton JT, Constable D, Senior V. Patients’ perceptions of Methicillin resistant staphylococcus aureus and source isolation: A qualitative analysis of source- isolated patients. J Hosp Infect 2001; 48 275–80.
| Patients’ perceptions of Methicillin resistant staphylococcus aureus and source isolation: A qualitative analysis of source- isolated patients.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3Mvht1ajtw%3D%3D&md5=8f7374c75726dd41dcafa7dafcbda352CAS |
[22] Madeo M. Understanding the MRSA experience. Nurs Times 2001; 97 36–7.
| 1:STN:280:DC%2BD383itVyhug%3D%3D&md5=5445360afb31b738a6606393ecc24fd3CAS |
[23] Ward D. Infection control: Reducing the psychological effects of isolation. Br J Nurs 2000; 9 162–70.
| 1:STN:280:DC%2BD3cvosF2ntA%3D%3D&md5=4d3196ff7cdfd0c81fd156e2a8dec0b5CAS |
[24] Knowles HE. The experience of infectious patients in isolation. Nurs Times 1993; 89 53–6.
| 1:STN:280:DyaK2c%2FltFKnsA%3D%3D&md5=c5700f63f68e7b92ead58e33838bedcdCAS |
[25] Bennett SM. “Patient perspective”… psychological effects of barrier nursing isolation. Australian Nursing Journal 1983; 12 36–7.
| 1:STN:280:DyaL3s3jtVGktw%3D%3D&md5=88f849e2d46366d3dad549702e44b0acCAS |
[26] Mays N, Pope C. Rigour in qualitative research. BMJ 1995; 311 109–12.
| Rigour in qualitative research.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2MzjvVSisA%3D%3D&md5=0466a5b57075c411970a02d06aac74d8CAS |
[27] Sandelowski M. Barosso J (2007) Handbook for synthesising qualitative research. New York, Springer Publishing Company.
[28] Finfgeld-Connett D. Generalisability and transferability of metasynthesis Research findings. J Adv Nurs 2010; 66 246–54.
| Generalisability and transferability of metasynthesis Research findings.Crossref | GoogleScholarGoogle Scholar |
[29] Skyman E, Sjonstrom HT, Hellstom L. Patients’ experiences of being infected with MRSA at a hospital and subsequently source isolated. Scandanavian Journal of Caring Science 2010; 24 101–107.
[30] Sarno EN, Pessolani MCV. Oldest and most feared disease. Lancet 2001; 358 S39
| Oldest and most feared disease.Crossref | GoogleScholarGoogle Scholar |
[31] Butt G. Stigma in the context of hepatitis C: Concept analysis. J Adv Nurs 2008; 62 712–24.
| Stigma in the context of hepatitis C: Concept analysis.Crossref | GoogleScholarGoogle Scholar |
[32] Kirkland KB. Taking Off the Gloves: Toward a Less Dogmatic Approach to the Use of Contact Isolation. Clinical Infectious Diseases 2009; 48 766–771.
[33] Gaskill D, Henderson A, Fraser M. Exploring the everyday world of patient in Isolation. Oncology Nursing Forum 1997; 24 695–700.
| 1:STN:280:DyaK2szgtlClsg%3D%3D&md5=a64c73c5370517be7eae7c45565b487dCAS |
[34] Morgan DJ, Diekema JD, Sepkowitz K, Perrencevich EN. Adverse outcomes associated with contact precautions: A review of literature. Am J Infect Control 2009; 37 85–93.
| Adverse outcomes associated with contact precautions: A review of literature.Crossref | GoogleScholarGoogle Scholar |
[35] Moore T. Making Sense of Sensory Deprivation. Journal of Nursing Times 1991; 87 36–8.
| 1:STN:280:DyaK3M7ktF2nsg%3D%3D&md5=96751782f292a573b2f0ab198e4b8cb0CAS |