Evaluation of Adherence to Isolation Guidelines in a Chilean Teaching Hospital

ISSUE: Knowledge about transmission of microorganisms is important for implementing strategies that avoid dissemination. The objective of this work was to evaluate critical aspects in fulfillment of isolation practices for pathologies transmitted by air and droplets in a teaching hospital with 650 beds. PROJECT: Review of clinical records of patients hospitalized between 1999 and 2000 with diagnosis of lung tuberculosis (TB), meningitis (MEN), and chicken pox (VAR). We determined the opportunity of isolation (within 24 hours), type and length of isolation, registration of indications, and responsibility. RESULTS: We analyzed records of 19 lung TB patients, 10 VAR, and 35 MEN (13 N. meningitidis, 5 S. pneumoniae, 1 H. influenzae, and 16 probably viral). We observed greater adherence in MEN (81%) probably due to higher perceptions of risk. Greater adherence comprised private rooms (94%), length and opportunity of isolation measures (91%). Lower adherence involved writing indications about type of isolation (63%) and indications by physician (53%). This is probably because isolation is culturally considered a nurse responsibility even though in VAR the medical indication was 80%. CONCLUSIONS: Differences in risk perception among health personnel can contribute to a lack of adherence. Isolation evaluation is crucial to avoid dissemination of pathogens.