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Protective Isolation in Hemopoietic Stem Cell Transplants: A Review of the Literature and Single Institution Experience

Peter McMinn, BmedSc, MBBS, PhD, FRCPA, FRCPath

ncology Total Care Unit, Princess Margaret Hospital for Children, GPO Box D184, Perth WA 6840

Leanne Monterosso, PhD, B Nurs (Hons), RN, RM, NNT, FRCNA

Princess Margaret Hospital for Children and a postdoctoral fellow in the School of Nursing & Public Health at Edith Cowan University

Princess Margaret Hospital for Children, Perth, Western Australia, is a pediatric bone marrow transplant center. This center has both laminar flow and HEPA- (high-efficiency particulate air-)filtered rooms for children under-going allogeneic and autologous transplantation. HEPA-filtered rooms on negative pressure are used to nurse oncology children with infectious diseases. Over the winter months of 2001, there was an increased demand for single rooms for children with infectious diseases. Over the same period, a number of transplants were planned. Consequently, to guide practice decisions, a review of the literature and a survey of nursing practice in Australian and North American pediatric oncology units were undertaken. Findings showed that protective isolation measures such as positive-pressure single rooms, low microbial diets, and strict hand washing should be used only for children requiring allogeneic transplants. Use of other isolation measures were found to be of no added value for transplantation. As autologous transplants are increasingly performed in outpatient clinics, these children should not require the same level of protective isolation.

Key Words: stem cell transplant • pediatric • nursing • protective isolation • infection control

Journal of Pediatric Oncology Nursing, Vol. 20, No. 6, 293-300 (2003)
DOI: 10.1177/1043454203254985


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