Development of a novel prevention bundle for pediatric healthcare-associated viral infections

Abstract

The iterative development, implementation, and refinement of targeted prevention practices was associated with a significant reduction in pediatric HAVI. These practices were ultimately formalized into a comprehensive prevention bundle and provide an important framework for both patient and systems-level interventions that can be applied year-round and across inpatient areas.

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

“…Our data indicate that VRPPs implemented in the winter at a freestanding children's hospital are associated with reduced hospital transmission of respiratory viruses compared with that in nonwinter months when VRPPs are not in place. Our findings are consistent with those of recently published studies at other large freestanding children's hospitals, which reported reduced HA-VRI incidence density after winter VRPP implementation [5,6]. The specific VRPPs implemented vary substantially among children's hospitals [3]; optimal VRPPs have not been defined yet.…”

“…Although VRPPs are often limited to the winter months when community incidence of RSV and influenza rises, our data also suggest that seasonal VRPPs can result in unacceptably frequent hospital transmission of respiratory viruses, particularly rhinovirus/enterovirus, during nonwinter months. A similar trend has been found in other pediatric studies [1,5,6], which demonstrates the high burden of HA-rhinovirus infections. Rhinoviruses and enteroviruses are often benign in otherwise healthy children.…”

“…The specific VRPPs implemented vary substantially among children's hospitals [3]; optimal VRPPs have not been defined yet. However, a bundled approach for HA-VRI prevention that includes winter visitation limitations, hand hygiene, visitor symptom screening, and close monitoring of routine infection-prevention practices has been shown to effectively reduce HA-VRI incidence density by 25% [5]. Despite HA-VRI reduction with VRPPs in our study and others, HA VRIs remain common in winter months, which suggests that additional strategies for reducing HA VRIs are needed.…”

“…Although nearly 90% of children's hospitals implement VRPPs [3], the effectiveness of these practices was characterized only recently in multiple single-center studies [5,6]. Our data indicate that VRPPs implemented in the winter at a freestanding children's hospital are associated with reduced hospital transmission of respiratory viruses compared with that in nonwinter months when VRPPs are not in place.…”

“…Frequent hospital transmission of rhinoviruses/enteroviruses in units that house immunocompromised children and other children at high risk for infection supports consideration of implementing yearround VRPPs for preventing RSV/influenza. In contrast to other recent studies of HA-VRI epidemiology [5,6], our study was strengthened by normalizing HA-VRI incidence data to inpatient CA-VRI burden. By using VRI transmission indices, rather than incidence density, as was done in a previous study of influenza and RSV [4], we limited bias related to profound differences in seasonal and year-to-year community incidences of many respiratory viruses.…”