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Syst Rev. 2015 Nov 7;4:152. doi: 10.1186/s13643-015-0131-2.

Use of ward closure to control outbreaks among hospitalized patients in acute care settings: a systematic review.

Author information

1
W21C Research and Innovation Centre, Cumming School of Medicine, University of Calgary, GD01 TRW Building, 3280 Hospital Drive NW, Calgary, Alberta, Canada, T2N 4Z6.
2
Health Sciences Library, Libraries and Cultural Resources, University of Calgary, HSC 1450, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, Canada, T2N 4N1.
3
Infection Prevention and Control, Alberta Health Services, #303 CSC, 10240 Kingsway, Edmonton, Alberta, Canada, T5H 3V9.
4
Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, 2D3.05 WMC, Edmonton, Alberta, Canada, T6G 2B7.
5
Department of Medicine, Cumming School of Medicine, 3280 Hospital Drive NW, Calgary, Alberta, Canada, T2N 4Z6.
6
Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, Canada, T2N 4Z6.
7
O'Brien Institute for Public Health, 3280 Hospital Drive NW, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, Canada, T2N 4Z6.
8
W21C Research and Innovation Centre, Cumming School of Medicine, University of Calgary, GD01 TRW Building, 3280 Hospital Drive NW, Calgary, Alberta, Canada, T2N 4Z6. john.conly@albertahealthservices.ca.
9
Infection Prevention and Control, Alberta Health Services, #303 CSC, 10240 Kingsway, Edmonton, Alberta, Canada, T5H 3V9. john.conly@albertahealthservices.ca.
10
Department of Medicine, Cumming School of Medicine, 3280 Hospital Drive NW, Calgary, Alberta, Canada, T2N 4Z6. john.conly@albertahealthservices.ca.
11
Snyder Institute for Chronic Diseases, 3280 Hospital Drive NW, Calgary, Alberta, Canada, T2N 4Z6. john.conly@albertahealthservices.ca.
12
Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, Canada, T2N 4Z6. john.conly@albertahealthservices.ca.
13
O'Brien Institute for Public Health, 3280 Hospital Drive NW, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, Canada, T2N 4Z6. john.conly@albertahealthservices.ca.

Abstract

BACKGROUND:

Though often used to control outbreaks, the efficacy of ward closure is unclear. This systematic review sought to identify studies defining and describing ward closure in outbreak control and to determine impact of ward closure as an intervention on outbreak containment.

METHODS:

We searched these databases with no language restrictions: MEDLINE, 1946 to 7 July 2014; EMBASE, 1974 to 7 July 2014; CINAHL, 1937 to 8 July 2014; and Cochrane Database of Systematic Reviews, 2005 to May 2014. We also searched the following: IndMED; LILACS; reference lists from retrieved articles; conference proceedings; and websites of the CDCP, the ICID, and the WHO. We included studies of patients hospitalized in acute care facilities; used ward closure as a control measure; used other control measures; and discussed control of the outbreak(s) under investigation. A component approach was used to assess study quality.

RESULTS:

We included 97 English and non-English observational studies. None included a controlled comparison between ward closure and other interventions. We found that ward closure was often used as part of a bundle of interventions but could not determine its direct impact separate from all the other interventions whether used in parallel or in sequence with other interventions. We also found no universal definition of ward closure which was widely accepted.

CONCLUSIONS:

With no published controlled studies identified, ward closure for control of outbreaks remains an intervention that is not evidence based and healthcare personnel will need to continue to balance the competing risks associated with its use, taking into consideration the nature of the outbreak, the type of pathogen and its virulence, mode of transmission, and the setting in which it occurs. Our review has identified a major research gap in this area.

PMID:
26546048
PMCID:
PMC4636845
DOI:
10.1186/s13643-015-0131-2
[Indexed for MEDLINE]
Free PMC Article

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