Association Between Children’s Hospital Visitor Restrictions and Healthcare-Associated Viral Respiratory Infections: A Quasi-Experimental Study

Forkpa, Hawa; Rupp, Angela; Shulman, Stanford T.; Patel, Sameer; Gray, Elizabeth; Zheng, Xiaotian; Bovee, Maria; Kociolek, Larry K.

doi:10.1093/jpids/piz023

Cited by 17 publications

(12 citation statements)

References 10 publications

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“…Although visitor restrictions are associated with decreased healthcare‐associated respiratory infection transmission, these restrictions are typically only implemented during winter and/or influenza season. This decreased visitor burden could be the explanation for the lack of influenza, and other winter respiratory viruses, seen during this study 25 . No patients received palivizumab to prevent RSV infection.…”

Section: Discussionmentioning

confidence: 79%

Frequency of asymptomatic and symptomatic respiratory virus detection in pediatric hematopoietic cell transplant patients

Schuster

Banerjee

Ahmed

et al. 2020

Pediatric Transplantation

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Respiratory viral infections are common and can cause significant morbidity and mortality in pediatric patients undergoing hematopoietic cell transplantation (HCT). The prevalence of disease has been primarily identified from retrospective studies using standard‐of‐care specimens. The incidence of both asymptomatic respiratory viral detection and symptomatic respiratory viral detection in this high‐risk population is not well described. We performed longitudinal, active, prospective surveillance in pediatric HCT patients. Subjects underwent weekly midturbinate swabs (MTSs) for the detection of 18 respiratory viruses and subtypes peri‐HCT and 100 days post‐HCT. Clinical data were obtained from the medical record. From September 2015 to February 2017, 24 children underwent 29 HCT, and 284 MTSs were collected. Forty‐two (15%) specimens were virus‐positive from 10 (42%) subjects. Specimens from children undergoing allogeneic HCT were more likely to have a virus detected (17% vs 8%, P = .04) compared with specimens from children undergoing autologous HCT. Sixteen (38%) detections were not associated with symptoms. Almost half (8/17) of the unique viral infections occurred during the HCT hospitalization after a negative specimen, suggesting nosocomial acquisition, and preceded detection from a clinical specimen. Rhinovirus, the most common virus detected, was the only virus detected in 33 (81%) virus‐positive specimens; only 11 (33%) rhinovirus detections were asymptomatic. Asymptomatic detection of coronavirus and bocavirus occurred. Asymptomatic respiratory virus detection occurred in more than one‐third of the children undergoing HCT. The acquisition of respiratory viruses during HCT hospitalization suggests nosocomial acquisition. Early detection of respiratory viruses during asymptomatic periods could have infection prevention and treatment implications.

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Section: Discussionmentioning

confidence: 79%

Frequency of asymptomatic and symptomatic respiratory virus detection in pediatric hematopoietic cell transplant patients

Schuster

Banerjee

Ahmed

et al. 2020

Pediatric Transplantation

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“…Since visiting restrictions has been one out of many precautions for infection control implemented within the healthcare services during the pandemic, no study that has distinguished the effects from such precaution measures have been found. However, visitor restrictions during the winter in a paediatric hospital were found to reduce hospital transmission of respiratory viruses (not specifically SARS COv-2) compared with when no restrictions were in place ( Forkpa et al, 2020 ). Another study reported a significant reduction in health care-acquired respiratory viral infections when implementing year around visiting restrictions ( Washam et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Consequences of visiting restrictions during the COVID‐19 pandemic: An integrative review

Hugelius

Harada

Marutani

2021

International Journal of Nursing Studies

252

207

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Background During the COVID-19 pandemic, visiting restrictions of different extents have been implemented. However, despite the long history of visiting restrictions in health care systems, little is known about their effects. Objectives This review sought to explore the consequences of visitor restrictions in health care services during the COVID-19 pandemic. Methods A systematic, integrative review was conducted in accordance with the PRISMA guidelines, based on a systematic search in PubMed, CHINAL full plus, Web of Science, PsychInfo, Scopus and the Cochrane Library. Results A total of 17 scientific papers covering intensive care, paediatric care, general medical care, hospital care, palliative care and nursing home settings were included. Although appreciation for the technical solutions enabling remote meetings was reported, visiting restrictions had several consequences, mainly negative, for the patient's health, the health and wellbeing of family members and the provision of care. Among physical health consequences, reduced nutrition intake, decreased activities of daily living and increased physical pain and symptoms were reported. Among mental health consequences for the patient, loneliness, depressive symptoms, agitation, aggression, reduced cognitive ability and overall dissatisfaction were observed. For family members, worry, anxiety and uncertainty occurred, and they reported an increased need for information from care providers. Family members of neonatal intensive care unit patients reported less bonding with their child and family relation disturbances due to the restrictions. For care providers, visiting restrictions added the burdens of ethical dilemmas, learning new technical means to enable social interaction and an increased demand for communication with families and providing social support to both family members and patients. Conclusions When implementing visiting restrictions in health care services, decision makers and nurses need to be aware of their potential negative effects and adapt the provision of care to compensate for such effects. Nurses in all sectors should be aware that visiting restrictions may affect patients, families, and health care services for longer than the actual pandemic. Since the level of evidence regarding effect from visiting restrictions is low, further studies is strongly needed.

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“…While visitor regulation can have a positive effect on the prevention of viral respiratory infections [ 50 , 51 ], reviews show that they can also have negative consequences for the mental and physical health of patients, the wellbeing of family members and the workload of care providers [ 52 , 53 ].…”

Section: Discussionmentioning

confidence: 99%

Infection control strategies for patients and accompanying persons during the COVID-19 pandemic in German hospitals: a cross-sectional study in March–April 2021

Bludau

Heinemann

Mardiko

et al. 2022

Journal of Hospital Infection

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Association Between Children’s Hospital Visitor Restrictions and Healthcare-Associated Viral Respiratory Infections: A Quasi-Experimental Study

Cited by 17 publications

References 10 publications

Frequency of asymptomatic and symptomatic respiratory virus detection in pediatric hematopoietic cell transplant patients

Frequency of asymptomatic and symptomatic respiratory virus detection in pediatric hematopoietic cell transplant patients

Consequences of visiting restrictions during the COVID‐19 pandemic: An integrative review

Infection control strategies for patients and accompanying persons during the COVID-19 pandemic in German hospitals: a cross-sectional study in March–April 2021

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