Neutropenia
Protective isolation: A variety of practices exist regarding the use of isolation for immunocompromised patients; however, the effectiveness of protective isolation has not been established. A randomized study of adult neutropenic patients with cancer demonstrated no difference in infection for patients in protective isolation compared to those not in isolation; another study supported the fi ndings, indicating no signifi cant differences in median days with a fever, number of days before the fi rst use of systemic antibiotics, or the use of antifungals (Mank & van der Lelie, 2003; Nauseef & Maki,1981). Although the published studies had small sample sizes, no statistically signifi cant differences existed in the incidence
of febrile episodes, the number of infections, or the use of antibiotics for patients in protective isolation and those not isolated. Because no evidence suggests that protective isola tion reduces the risk of infection, the practice is no longer recommended (Larson & Nirenberg, 2004; Sehulster & Chinn, 2003; Shelton, 2003). However, healthcare providers should continue to recommend that neutropenic patients avoid or minimize exposure to potentially infectious people. Visitors should be screened for symptoms indicating potential respiratory infection and instructed not to visit patients if an infection is found (Larson & Nirenberg).