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An Australian interpretive description of Contact Precautions through a bioethical lens; recommendations for ethically improved practice

Citation

Harris, J and Maxwell, H and Dodds, SM, An Australian interpretive description of Contact Precautions through a bioethical lens; recommendations for ethically improved practice, American journal of infection control, 22 pp. 1-26. ISSN 0196-6553 (2022) [Refereed Article]

Copyright Statement

2022 Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.

Official URL: https://www.ajicjournal.org/article/S0196-6553(22)...

DOI: doi:10.1016/j.ajic.2022.08.010

Abstract

Background: Contact Precautions (CP) were developed to control multi-resistant organisms (MROs) in hospitals. However, MROs persist and harms are associated with CP. Research objectives were to understand the bioethical impact of CP on patients and health-professionals, and make recommendations for ethically-improved management of MRO-colonised patients.

Method: Interpretive description methodology scaffolded upon bioethical principles framed this qualitative study. Findings were explored alongside contemporary published reports to make recommendations for practice and research.

Results: 9 patients and 24 health professionals participated. Four themes were found: Powerlessness moving to acceptance; You feel a bit of a pariah; Others need protection, but I need looking after too; Doing Contact Precautions is not easy.

Discussion: CP conflict with the principle of respect for autonomy due to non-adherence to informed consent, and sub-optimal communication. Patients experience healthcare inequality, and discriminatory practices breaching the principle of justice. CP elicit stigma for patients, and moral distress and inter-personal conflict for staff, breaching the principle of non-maleficence. Under the principle of beneficence, pluralistic cost-benefit assessment situates CP as low-value practice.

Conclusion: CP challenge organisational culture, professional well-being, and person-centred ethical care. Ethical costs of CP outweigh benefits, obliging policy-makers to reconsider CP in managing MRO-colonised patients.

Item Details

Item Type:Refereed Article
Keywords:Multi-resistant organisms; interpretive description; antibiotic resistance; isolation; contact precautions; stigma; benefit; harm; ethical.
Research Division:Health Sciences
Research Group:Nursing
Research Field:Acute care
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Disease distribution and transmission (incl. surveillance and response)
UTAS Author:Maxwell, H (Dr Hazel Maxwell)
UTAS Author:Dodds, SM (Professor Susan Dodds)
ID Code:152654
Year Published:2022
Deposited By:Health Sciences
Deposited On:2022-08-23
Last Modified:2022-09-08
Downloads:0

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