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Table 6 Summary table for accepted studies—infection prevention and control policies and specific interventions

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

  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
García 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)
  1. d days, w weeks, m months, y years