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Study finds norovirus can be contained without closing wards

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Closing a whole hospital ward to contain a norovirus outbreak is not always necessary, a UK study by infection control nurses has found.

Health Protection Agency guidance currently recommends wards are closed in the event of an outbreak and reopened 48 hours after the resolution of symptoms in the last new case.

But in one of the first studies of its kind, researchers from Derriford Hospital in Plymouth tested a strategy of isolating infectious patients in single rooms or bays over four years.

With scrupulous cleaning and strict infection control practices, they found in many cases it was possible to contain the virus in the bay.

Derriford Hospital has 1,200 beds spread across 42 wards, each of which has between three and seven single rooms, with the remaining beds configured in five or six bedded bays.

Under the new norovirus management strategy, infected patients were isolated in single rooms or bays, where they may be grouped together with other symptomatic patients. But the whole ward was not closed unless patients in more than two bays were infected.

Before the change in strategy was introduced in June 2007 90% of outbreaks were managed with the closure of a whole ward. Afterwards it was only necessary to manage 54% of cases in this way.

The researchers found the new way of working led to a major reduction in the average number of bed days lost per norovirus outbreak – from a median of 180 before June 2007 to 96 afterwards. The average number of patients affected during each outbreak also fell slightly from 17 to 14.

The study found infection control nurses were required to spend more time providing advice on the appropriate cohorting of patients as the length of outbreaks reduced, but overall there was no extra demand on their time.

The study was conducted by the trust’s infection control nurses and its director of infection prevention and control Dr Peter Jenks. The results have now been shared with other hospitals in the South West.

Dr Jenks said: “By compartmentalising our wards, we have managed to reduce the serious impact norovirus has on other patients needing care, and on the general running of a hospital.

“This is good news not just for us but for other hospitals wanting to replicate our model.”

A spokesman for the Healthcare Infection Society said it was an important study, provided useful data supporting the management of ward outbreaks without complete closure.

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Readers' comments (1)

  • The bays do not always have doors on them, so as one of the modes of transmission of Norovirus is airborne, the virus can still spread within the ward and infect other patients. I think that they don't want to completely close the wards because of capacity issues, so they have decided that they now don't need to. I work at Derriford and know how the wards are set up there.

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