The Impact of Strict Isolation on MRSA Positive Patients: An Action-Based Study Undertaken in a Rehabilitation Center Kristine L. Webber, BA  Sherry Macpherson, MSW RSW  Angela Meagher, MN RN-NP CRN(c)  Susan Hutchinson, PhD  Blair Lewis, MDiv BA This action based, qualitative research project was undertaken with inpatient participants at a physical medicine reha- bilitation center. Purpose: The objective of the research was to seek insights from rehabilitation inpatients with Methicillin-resistant Staphylococcus aureus (MRSA), to better understand their experience of MRSA and strict isolation. Method: Researchers and patients shared ideas for developing action plans to help improve supportive rehabilitation services for patients with MRSA. Nine patients participated in interviews and four participated in a follow-up focus group. Summarized patient data were disseminated during two interprofessional staff focus groups. Cumulated data were integrated into eight plans of action. Findings: The research resulted in immediate implementation of four action plans and ongoing development of four additional action plans. Clinical relevance: The research outcomes have contributed to improved MRSA educational resources and support- ive services for patients with MRSA. Introduction Methicillin-resistant Staphylococcus aureus (MRSA) is on the rise in Canadian hospitals and is increas- ing in numbers within the rehabilitation population (Minary-Dohen, Bailly, Bertrand & Talon, 2003; Si- mor et al., 2001, 2005; Zoutman et al., 2003). Patients in MRSA isolation may have reduced access to rehabilitation services, programs, and shared social space (Pike & McLean, 2002). Oppor- tunities for patients with MRSA to engage with oth- ers and to experience the full spectrum of rehabilitation services may therefore be compro- mised (Meagher, 2004; Pike & McLean, 2002; Ward, 2000). Research evidence has shown that long-term iso- lation may have a negative impact on patients’ emotional well-being (Gammon, 1998, 1999; New- ton, Constable & Senior, 2001; Ward, 2000). Few studies have explored the experiences of isolated patients with MRSA in a rehabilitation setting, where patients are encouraged to work closely with healthcare staff to regain or improve their indepen- dence and physical functioning. This action-based, qualitative research study was undertaken with inpatient participants at a rehabilitation center between the years 2007 and 2009. The objective of the research was to seek insights from patients with MRSA, to better understand the rehabilitation patients’ experience of MRSA and strict isolation. A second objective was to share patients’ ideas with healthcare staff to develop action plans to help improve experiences of MRSA-related isolation. Literature Review Methicillin-resistant Staphylococcus aureus and strict isolation impacts patients’ psychological and emotional well-being (Gammon, 1998, 1999; Lindberg, Carlsson, Högman & Skytt, 2009; Mackenzie & Edwards, 1997; Newton et al., 2001; Tarzi, Kennedy, Stone & Evans, 2001; Ward, 2000). Patients in MRSA isolation often show reduced ability to cope with hospitalization and may experi- ence a sense of loss of control (Gammon, 1998, 1999). Patients who have MRSA may also experi- ence a sense of confinement, or abandonment and may experience increased anxiety (Gammon, 1998; Kennedy & Hamilton, 1997; Madeo, 2001; Tarzi et al., 2001). Isolated patients sometimes experience anger (Kennedy & Hamilton, 1997) and may feel stigmatized by healthcare providers (Mackenzie & Edwards, 1997). Isolated patients sometimes feel that they are receiving lower quality of care Rehabilitation NURSING KEY WORDS action research interprofessional MRSA rehabilitation practice strict isolation Rehabilitation Nursing  Vol. 37, No. 1  January 2012 43