Objective: To determine isolation bed use for community-acquired and nosocomial infections in a pediatric hospital.
Design: A prospective repeated point prevalence survey was conducted during a 14-month period. A questionnaire was sent to other free-standing Canadian children's hospitals to determine isolation practice and perceived needs.
Setting: A university-affiliated, 218-bed pediatric hospital in Halifax, Nova Scotia, Canada.
Patients: All inpatients on surveyed wards during the study period (n = 1634).
Results: Overall, 13.5% of patients required isolation (range 5.6% to 31% per month). Demand was seasonal, with 71% of isolation occurring from November to April. Demand exceeded supply by 2 to 22 beds (11% to 122%). Respiratory and enteric infections requiring contact isolation accounted for 80% of use (53% and 27%, respectively). Children younger than 24 months comprised 28% of admissions and used 57% of isolation beds. Of patients isolated, 25% had nosocomial infections and 75% had community-acquired infections. The percentage of infant rooms in Canadian children's hospitals that were single bed (considered optimal for infant isolation) varied: 0% to 20% for hospitals built before 1965 and 25% to 47% for newer hospitals. All hospitals with less than 33% single-bed infant rooms perceived this allocation to be inadequate (p < 0.01 Fisher Exact Test).
Conclusions: Pediatric isolation bed use varies with patient age, season of year, and category-specific isolation requirements. An increasing need for single-bed rooms is identified. Isolation requirements must be considered during the design of new hospitals or renovation of existing ones.