Fifteen studies were included in the review (n=1,072 patients, range 19 to 234): one randomised controlled trial (RCT) (n=70), seven case control studies (n=689), six prospective cohort studies (n=294) and one retrospective study (n=19).
Psychological wellbeing: Most studies that assessed this outcome found a negative impact on depression and anxiety scores (four studies), anger-hostility scores (one study) and reported fear and loneliness (two studies).
Patient contact and satisfaction: Three of five studies reported statistically significantly less patient contact on at least one of the assessed parameters; the other two studies found no differences in quantity or quality of care between isolated and non-isolated patients.
Two studies assessed patient satisfaction. One study showed no differences between patients in isolation and those not in isolation; isolated patients reported positive views of the impact of isolation on their care. The other study reported greatest patient satisfaction when patients felt well informed about their care. A third study that primarily evaluated patient safety found that patients in isolation made statistically significantly more formal and informal complaints about their care (30% versus 8%, p<0.001).
Patient safety: One study assessed patient safety and found that patients in isolation experienced worse care and more adverse events on a wide range of measures. These ranged from incomplete recordings of vital signs (14% versus 9%, p<0.001) to incidence of preventable events (20 versus three, p<0.001) when non-preventable events did not differ. Severe adverse events and death rates did not differ between the groups.