A phenomenological exploration of source isolation in patients infected with multi-drug resistant organisms.

Background: The physical isolation of patients colonised or infected with multi-drug resistant organisms is a requirement in hospitals considering the risk of infecting other patients, healthcare workers and visitors. However, how these patients experience isolation in the current environment is not fully understood from the literature.

Aims: To explore and interpret the lived experience of the source isolation in patients infected with MDROs within an Australian setting.

Design: Hermeneutic phenomenology was utilised as the philosophical framework.

Methods: Unstructured in-depth face to face interviews were conducted with 20 patients infected with multi-drug resistant organisms who were physically isolated. Data was collected from February-2018 to January-2019 at two large teaching hospitals in the Sydney metropolitan area. The interviews were recorded, transcribed verbatim, analysed using thematic analysis by three researchers, and then subsequently interpreted, drawing insights from the relevant phenomenological notions.

Results: Three key findings emerged from the study as: Living in a changed space - developed from the participants' struggle to cope with being physically confined to a room that made them feel imprisoned. Living in a changed body - emerged from the participants who described their bodies as 'different' because of bacteria that conventional medicine could not destroy permanently but kept relapsing. Striving to survive - developed from participants who spoke about means of enduring some unfavourable experiences.

Conclusion: The essence of the lived experience of the phenomenon of source isolation from the perspectives of patients who become infected with MDROs emerged as Being-in-a-changed-world.

Impact: While source isolation is an important procedure for preventing and controlling transmissible infection; it often results in adverse psychological experiences. An understanding of this finding from the patients' perspectives is essential for nurses and other healthcare workers involved in their care to maintain a balance between infection control isolation and psychological needs.