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Am J Infect Control. 2013 May;41(5):433-7. doi: 10.1016/j.ajic.2012.05.024. Epub 2012 Sep 11.

Time lag for posting transmission-based isolation precaution signs.

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Department of Information Services, New York-Presbyterian Hospital, New York, NY, USA.



Rapid identification and isolation of patients colonized or infected with virulent pathogens is essential to minimize risk of exposure to other patients, visitors, and health care workers.


Our objective was to determine the time lag between when a patient is identified as requiring isolation precautions and when an isolation sign is posted outside of their room.


Patients requiring assessment of isolation precautions because of a new positive culture, readmission, or transfers within the institution were identified through an electronic surveillance system. Observers recorded the presence of isolation signs at the patient's door at time (T) 0hr, T2hr, T4hr, T24hr, and T48hr or until an isolation sign was posted.


The majority of patients was adults in nonintensive care units. Isolation signs were present for 79.0% of the patients at T0hr and increased to 83.8% by T48hr. No difference was seen between the unit type or indications for isolation. The most common organisms for which isolation was indicated were influenza and resistant enterococci, Staphylococcus aureus; isolation sign postings at T0hr were 87.9%, 85.7%, and 80.7%, respectively. There was a significant difference seen in compliance among the adult (82.8%) and pediatrics (66.7%) sites (P = .0268).


Isolation precautions are indicated to prevent transmission of virulent pathogens; however, their implementation in a timely manner can be challenging. In this study, approximately 20% of patients for whom isolation was needed had no sign posted within the first 24 hours, and there were only minimal increases thereafter. Simple processes are needed for early identification of patients, communication of the protective equipment needed, and continuous monitoring of adherence to guidelines.

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