Hall Joanna, Roopnarine Sharmela, McLean Jane
Barts and The London NHS Trust and City University, London.
Paediatr Nurs. 2007 Nov;19(9):14-7. doi: 10.7748/paed2007.11.19.9.14.c6279.
Where and how to care for children with infections, or those requiring protection, is a daily debate in many paediatric settings. The practice of placing patients into single rooms for infection control purposes is well documented but there is little guidance on when to remove patients from isolation rooms. Unless the appropriateness of isolation for each patient is evaluated daily, the availability of cubicles falls, resulting in potentially unnecessary transfers to other hospitals where such facilities are available. A new isolation policy was introduced to improve the availability of isolation rooms on paediatric wards in a large inner city teaching hospital with over 100 paediatric inpatient beds. A change management framework was used that included empowering organisational action and consolidating improvements. A number of strategies were introduced to prompt daily review of children in isolation, including clear criteria for isolation and nursing staff in the emergency department challenging the decision to admit a child into an isolation room. Introduction of the policy and subsequent audits have resulted in improved staff awareness, more effective use of isolation rooms and reduced transfers to other hospitals.
在许多儿科环境中，关于在何处以及如何护理感染儿童或需要保护的儿童，是每天都会讨论的问题。出于感染控制目的将患者安置在单人病房的做法已有充分记录，但对于何时将患者从隔离病房转出却几乎没有指导意见。除非每天对每位患者隔离的适宜性进行评估，否则隔离病房的可用性就会降低，从而导致可能不必要地转至有此类设施的其他医院。在一家拥有100多张儿科住院床位的大型市中心教学医院，引入了一项新的隔离政策，以提高儿科病房隔离病房的可用性。采用了一个变革管理框架，其中包括推动组织行动和巩固改进成果。引入了一些策略来促使对隔离中的儿童进行每日评估，包括明确的隔离标准，以及急诊科的护理人员对收治儿童进入隔离病房的决定提出质疑。该政策的实施及随后的审计提高了工作人员的意识，更有效地利用了隔离病房，并减少了转至其他医院的情况。
