Helsinki Committee for Human Rights

 

 

 

 

 

 

 

 

Isolation (health care)

In health care facilities, isolation represents one of several measures that can be taken to implement infection control: the prevention of contagious diseases from being spread from a patient to other patients, health care workers, and visitors, or from outsiders to a particular patient (reverse isolation). Various forms of isolation exist, in some of which contact procedures are modified, and others in which the patient is kept away from all others. In a system devised, and periodically revised, by the U.S. Centers for Disease Control and Prevention (CDC), various levels of patient isolation comprise application of one or more formally described "precaution".

Universal precautions refer to the practice, in medicine, of avoiding contact with patients' bodily fluids, by means of the wearing of nonporous articles such as medical gloves, goggles, and face shields. The practice was widely introduced in 198588. In 1987, the practice of universal precautions was adjusted by a set of rules known as body substance isolation. In 1996, both practices were replaced by the latest approach known as standard precautions. Use of personal protective equipment is now recommended in all health settings.

Special equipment is used in the management of patients in the various forms of isolation. These most commonly include items of personal protective equipment (gowns, masks, and gloves) and engineering controls (positive pressure rooms, negative pressure rooms, laminar air flow equipment, and various mechanical and structural barriers). Dedicated isolation wards may be pre-built into hospitals, or isolation units may be temporarily designated in facilities in the midst of an epidemic emergency.

Strict isolation is used for diseases spread through the air and in some cases by contact. Patients must be placed in isolation to prevent the spread of infectious diseases. Those who are kept in strict isolation are often kept in a special room at the facility designed for that purpose. Such rooms are equipped with a special lavatory and caregiving equipment, and a sink and waste disposal are provided for workers upon leaving the area.

Contact isolation is used to prevent the spread of diseases that can be spread through contact with open wounds. Health care workers making contact with a patient on contact isolation are required to wear gloves, and in some cases, a gown.

Reverse isolation is a way to prevent a patient in a compromised health situation from being contaminated by other people or objects. It often involves the use of laminar air flow and mechanical barriers (to avoid physical contact with others) to isolate the patient from any harmful pathogens present in the external environment.

Disease isolation is relevant to the work and safety of health care workers. Health care workers may be regularly exposed to various types of illnesses and are at risk of being getting sick. Disease spread can occur between a patient and a health care worker, even if the health care workers takes all necessary precautions to minimize transmission, including proper hygiene and being up-to-date with vaccines. If a health care gets sick with a communicable disease, possible spread may occur to other health care workers or susceptible patients within the health care facility. This can include patients with a weakened immune system and may be at risk for serious complications.

Disease isolation is rarely disputed for its importance in protecting others from disease. However, it is important to consider the consequences disease isolation may have on an individual. For instance, patients may not be able to receive visitors, and in turn, become lonely. Patients may experience depression, anxiety, and anger. Small children may feel their isolation is a punishment. Staff may need to spend more time with patients. Patients may not be able to receive certain types of care due to the risk that other patients may become contaminated. This includes forms of care that involve use of equipment common to all patients at the facility, or that involve transporting the patient to an area of the facility common to all patients. Given the impact of isolation on patients, social and emotional support may be needed.

Disease isolation can also be justified as a morally legitimate ethical practice in public health based on the reciprocal relationship between the individual and the state. The individual is obligated to protect others by preventing further spread of disease, respect the instructions from public health authorities and sequester themselves in their homes and not attend public gatherings, and act as a first responder (if a healthcare professional) by providing services to protect and restore public health. The state, on the other hand, is obligated to provide support to individuals burdened as a result of restrictive measures (e.g. compensation for missed work, providing access to food and other necessities for those quarantined and isolated, assistance for first responders to balance personal/professional obligations), ensure several legal protections are in place for those subjected to restrictive measures, and communicate all relevant information regarding the necessity of restriction.

 

 

 

 

 

 

 

 

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U.S. HELSINKI COMMISSION TO HOLD HEARING ON HUMAN TRAFFICKING AND TRANSNATIONAL ORGANIZED CRIME

November 2, 2011

10:00 a.m. - 11:30 a.m.

Please join the Commission on Security and Cooperation in Europe for a hearing that explores the nexus between Transnational Organized Crime and Human Trafficking.

Organized Crime has evolved to meet the challenges of globalization and modern technology. In this evolution major international criminal organizations and smaller highly specialized groups of criminal entrepreneurs have found new ways to expand their operations and exploit human beings into slavery. To meet these challenges new national and international strategies have been placed into action, but their results remain to be seen. This continues the Helsinki Commission’s hearing series on new fronts in human trafficking. This hearing will focus on: (1) the evolving nature of Transnational Organized Crime, (2) the role of major international organized crime groups and smaller organized criminal syndicates in human trafficking, (3) identified trends, and (4) strategies to combat these organizations and prevent the trafficking of human beings.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Copyright * Helsinki Committee for Human Rights 2011