Cargando…
Focusing on Families and Visitors Reduces Healthcare Associated Respiratory Viral Infections in a Neonatal Intensive Care Unit
Healthcare-associated respiratory viral infections (HARVIs) result in significant harm to infants in the neonatal intensive care unit (NICU). Healthcare workers and visitors can serve as transmission vectors to patients. We hypothesized that improved family and visitor hand hygiene (FVHH) and visito...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946222/ https://www.ncbi.nlm.nih.gov/pubmed/32010868 http://dx.doi.org/10.1097/pq9.0000000000000242 |
_version_ | 1783485314932670464 |
---|---|
author | Linam, W. Matthew Marrero, Elizabeth M. Honeycutt, Michele D. Wisdom, Christy M. Gaspar, Anna Vijayan, Vini |
author_facet | Linam, W. Matthew Marrero, Elizabeth M. Honeycutt, Michele D. Wisdom, Christy M. Gaspar, Anna Vijayan, Vini |
author_sort | Linam, W. Matthew |
collection | PubMed |
description | Healthcare-associated respiratory viral infections (HARVIs) result in significant harm to infants in the neonatal intensive care unit (NICU). Healthcare workers and visitors can serve as transmission vectors to patients. We hypothesized that improved family and visitor hand hygiene (FVHH) and visitor screening would reduce HARVIs by at least 25%. METHODS: This quality improvement project took place in a large tertiary NICU to reduce HARVIs. Interventions primarily focused on improving FVHH and reducing visitation by symptomatic family members and visitors. We defined correct FVHH as hand hygiene performed immediately before touching their child. Hand hygiene observations were performed by direct observation by NICU staff using a standardized tool. Interventions to improve FVHH included education of staff and visitors, reminder signs, and immediate reminders to families to prevent lapses in hand hygiene. Staff screened family and visitors before NICU entry. Symptomatic individuals were asked to defer visitation until symptoms resolved. HARVIs were identified during prospective surveillance by infection preventionists using standard definitions. RESULTS: Baseline FVHH was 27% in 2015. After May 2017, the average FVHH remained at 85%. When reminded, family members and visitors performed hand hygiene 99% of the time. Staff screened ~129,000 people for FVHH. Between January 2013 and March 2019, there were 74 HARVIs; 80% were rhinovirus/enterovirus. After the implementation of improved FVHH, the HARVI rate decreased from 0.67 to 0.23/1,000 patient days. CONCLUSIONS: Adding interventions to improve FVHH and visitor management to existing healthcare worker prevention efforts can help reduce HARVIs in the NICU. |
format | Online Article Text |
id | pubmed-6946222 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-69462222020-01-31 Focusing on Families and Visitors Reduces Healthcare Associated Respiratory Viral Infections in a Neonatal Intensive Care Unit Linam, W. Matthew Marrero, Elizabeth M. Honeycutt, Michele D. Wisdom, Christy M. Gaspar, Anna Vijayan, Vini Pediatr Qual Saf Individual QI Projects from Single Institutions Healthcare-associated respiratory viral infections (HARVIs) result in significant harm to infants in the neonatal intensive care unit (NICU). Healthcare workers and visitors can serve as transmission vectors to patients. We hypothesized that improved family and visitor hand hygiene (FVHH) and visitor screening would reduce HARVIs by at least 25%. METHODS: This quality improvement project took place in a large tertiary NICU to reduce HARVIs. Interventions primarily focused on improving FVHH and reducing visitation by symptomatic family members and visitors. We defined correct FVHH as hand hygiene performed immediately before touching their child. Hand hygiene observations were performed by direct observation by NICU staff using a standardized tool. Interventions to improve FVHH included education of staff and visitors, reminder signs, and immediate reminders to families to prevent lapses in hand hygiene. Staff screened family and visitors before NICU entry. Symptomatic individuals were asked to defer visitation until symptoms resolved. HARVIs were identified during prospective surveillance by infection preventionists using standard definitions. RESULTS: Baseline FVHH was 27% in 2015. After May 2017, the average FVHH remained at 85%. When reminded, family members and visitors performed hand hygiene 99% of the time. Staff screened ~129,000 people for FVHH. Between January 2013 and March 2019, there were 74 HARVIs; 80% were rhinovirus/enterovirus. After the implementation of improved FVHH, the HARVI rate decreased from 0.67 to 0.23/1,000 patient days. CONCLUSIONS: Adding interventions to improve FVHH and visitor management to existing healthcare worker prevention efforts can help reduce HARVIs in the NICU. Wolters Kluwer Health 2019-12-16 /pmc/articles/PMC6946222/ /pubmed/32010868 http://dx.doi.org/10.1097/pq9.0000000000000242 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Individual QI Projects from Single Institutions Linam, W. Matthew Marrero, Elizabeth M. Honeycutt, Michele D. Wisdom, Christy M. Gaspar, Anna Vijayan, Vini Focusing on Families and Visitors Reduces Healthcare Associated Respiratory Viral Infections in a Neonatal Intensive Care Unit |
title | Focusing on Families and Visitors Reduces Healthcare Associated Respiratory Viral Infections in a Neonatal Intensive Care Unit |
title_full | Focusing on Families and Visitors Reduces Healthcare Associated Respiratory Viral Infections in a Neonatal Intensive Care Unit |
title_fullStr | Focusing on Families and Visitors Reduces Healthcare Associated Respiratory Viral Infections in a Neonatal Intensive Care Unit |
title_full_unstemmed | Focusing on Families and Visitors Reduces Healthcare Associated Respiratory Viral Infections in a Neonatal Intensive Care Unit |
title_short | Focusing on Families and Visitors Reduces Healthcare Associated Respiratory Viral Infections in a Neonatal Intensive Care Unit |
title_sort | focusing on families and visitors reduces healthcare associated respiratory viral infections in a neonatal intensive care unit |
topic | Individual QI Projects from Single Institutions |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946222/ https://www.ncbi.nlm.nih.gov/pubmed/32010868 http://dx.doi.org/10.1097/pq9.0000000000000242 |
work_keys_str_mv | AT linamwmatthew focusingonfamiliesandvisitorsreduceshealthcareassociatedrespiratoryviralinfectionsinaneonatalintensivecareunit AT marreroelizabethm focusingonfamiliesandvisitorsreduceshealthcareassociatedrespiratoryviralinfectionsinaneonatalintensivecareunit AT honeycuttmicheled focusingonfamiliesandvisitorsreduceshealthcareassociatedrespiratoryviralinfectionsinaneonatalintensivecareunit AT wisdomchristym focusingonfamiliesandvisitorsreduceshealthcareassociatedrespiratoryviralinfectionsinaneonatalintensivecareunit AT gasparanna focusingonfamiliesandvisitorsreduceshealthcareassociatedrespiratoryviralinfectionsinaneonatalintensivecareunit AT vijayanvini focusingonfamiliesandvisitorsreduceshealthcareassociatedrespiratoryviralinfectionsinaneonatalintensivecareunit |