Introduction
Healthcare-associated viral infections (HAVI) are a common cause of patient harm in
the pediatric population. We implemented a HAVI prevention bundle in 2015, which included
6 core elements: caregiver screening, symptom-based isolation, personal protective
equipment (PPE), hand hygiene, staff illness procedures, and monitoring of environmental
cleanliness. Enhanced bundle elements were introduced at the start of the COVID-19
pandemic, which provided an opportunity to observe the effectiveness of the bundle
with optimal adherence to prevention practices, and to measure the impact on respiratory
HAVI epidemiology.
Methods
Respiratory HAVIs were confirmed through review of medical records and application
of the National Health Safety Network (NHSN) surveillance criteria for upper respiratory
infections (URIs) with predetermined incubation periods for unit attribution. Descriptive
statistics of the study population were examined, and comparative analyses were performed
on demographic and process metrics. Data analysis was conducted using R statistical
software.
Results
We observed an overall decrease in respiratory HAVI of 68%, with prepandemic rates
of 0.19 infections per 1,000 patient significantly decreased to a rate of 0.06 per
1,000 patient days in the pandemic period (P < .01). Rhinovirus made up proportionally more of our respiratory HAVI in the pandemic
period (64% vs 53%), with respiratory HAVI secondary only to rhinovirus identified
during 8 of 16 months in the pandemic period. Compliance with our HAVI prevention
bundle significantly improved during pandemic period.
Conclusions
Enhancement of our HAVI bundle during the COVID-19 pandemic contributed toward significant
reduction in nosocomial transmission of respiratory HAVI. Even with prevention practices
optimized, respiratory HAVIs secondary to rhinovirus continued to be reported, likely
due to the capacity of rhinovirus to evade bundle elements in hospital, and infection
prevention efforts at large in the community, leaving vulnerable patients at continued
risk.
Graphical abstract
Graphical Abstract
Key Words
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Article Info
Publication History
Published online: May 16, 2022
Publication stage
In Press Journal Pre-ProofFootnotes
Conflicts of interest: None to report.
Identification
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© 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
