Table 6 Summary table for accepted studies—infection prevention and control policies and specific interventions
| Â | Setting (beds); country | Study length | Definition of ward closure | Main interventions | Outcomes |
|---|---|---|---|---|---|
Gastrointestinal: norovirus | |||||
Haill et al. [13] | Teaching hospital (1200); England | 2005–2011 | Unspecified closure | 2005–2007: ward closure; meet criteria before reopening; terminal cleaning | Many norovirus outbreaks can be controlled by bay closures when combined with adequate infection control support |
2007–2011: isolation and cohorting in bays to facilitate disinfection | New policy led to reduction in: duration of closure from 6d to 5d and bed-days lost from 180 to 96 | ||||
Illingworth et al. [12] | Teaching hospital (1100); England | 2006–2010 | Unspecified bay closures | 2006–2008: Early ward closure | New policy led to significant reduction in: length of closure (p < 0 .041) and in bed-days lost (p < 0.001) |
2008–2010: Closure of ward bays; architectural installation; environmental disinfections; enlarged infection control team | |||||
Other and multiple/mixed systems with predominant infection Acinetobacter baumannii | |||||
GarcÃa et al., 2009 [114] | 2 ICUs (30, 24) at a tertiary hospital (934); Spain | 2006–2007 | Unspecified sequential closure | Cleaning/disinfection (intervention); clinical procedures limited; isolation; dedicated HCW; contact precautions; HCW and environmental screening; education | Cleaning/disinfection led to a decrease from 3.2 to 1.6 episodes per 100 patients, and incidence density of 9.2 to 5 infections per 1000d of stay |
Other and multiple/mixed systems with combination of colonization and infection: Staphylococcus aureus | |||||
Farrington et al. [111] | Teaching hospital (1000); England | 1985–1997 | No new admissions; limited transfers | 1985–1994: MRSA screening upon admission to ICU; isolation; ward closure; disinfection | Relaxation of policy and increase MRSA upon admission led to an increased in MRSA cases from 1 to 2 in 1994 to 74 cases in 1997 |
1994–1997: relaxed closure/reopen and screening criteria | |||||
Selkon et al. [112] | General hospital (1000 beds); England | 1967–1978 | Unspecified closure | 1967–1972: ward closure; standard barrier nursing methods | Ward closure and barrier nursing did not control the outbreaks |
1972–1978: limited transfer; construction of a isolation unit with control ventilation | New policy led to reduction in incidence rate of MRSA infection from 6.57 to 5.08 cases per 1000 admissions; from 130 to 14 cases of infection | ||||
Combination of colonization and infection: Clostridium difficile and Staphylococcus aureus | |||||
Stone et al. [113] | Acute medical wards (66) at an acute geriatrics hospital; England | 1994–1996 | Unspecified closure | 1994–1995: ward closure; national guidelines | Ward closure and national guidelines did not control the outbreaks |
1995–1996: hand hygiene; education/ communication; antimicrobial treatment restricted | New policy led to reduction in: incidence rate of C. difficile infection from 3.35 cases to 1.94 cases per 100 admissions (p < 0.05), and MRSA incidence from 3.95 to 194 cases per 100 admissions (p < 0.01) | ||||