PMID- 30027857
OWN - NLM
STAT- MEDLINE
DCOM- 20190712
LR  - 20200205
IS  - 1559-6834 (Electronic)
IS  - 0899-823X (Linking)
VI  - 39
IP  - 9
DP  - 2018 Sep
TI  - Development of a novel prevention bundle for pediatric healthcare-associated 
      viral infections.
PG  - 1086-1092
LID - 10.1017/ice.2018.149 [doi]
AB  - OBJECTIVE: To reduce the healthcare-associated viral infection (HAVI) rate to 
      0.70 infections or fewer per 1,000 patient days by developing and sustaining a 
      comprehensive prevention bundle. SETTING: A 546-bed quaternary-care children's 
      hospital situated in a large urban area.PatientsInpatients with a confirmed HAVI 
      were included. These HAVIs were identified through routine surveillance by 
      infection preventionists and were confirmed using National Healthcare Safety 
      Network definitions for upper respiratory infections (URIs), pneumonia, and 
      gastroenteritis. METHODS: Quality improvement (QI) methods and statistical 
      process control (SPC) analyses were used in a retrospective observational 
      analysis of HAVI data from July 2012 through June 2016. RESULTS: In total, 436 
      HAVIs were identified during the QI initiative: 63% were URIs, 34% were 
      gastrointestinal infections, and 2.5% were viral pneumonias. The most frequent 
      pathogens were rhinovirus (n=171) and norovirus (n=83). Our SPC analysis of HAVI 
      rate revealed a statistically significant reduction in March 2014 from a monthly 
      average of 0.81 to 0.60 infections per 1,000 patient days. Among HAVIs with event 
      reviews completed, 15% observed contact with a sick primary caregiver and 15% 
      reported contact with a sick visitor. Patient outcomes identified included care 
      escalation (37%), transfer to ICU (11%), and delayed discharge (19%). 
      CONCLUSIONS: 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.
FAU - Hei, Hillary
AU  - Hei H
AD  - Infection Prevention and Control, Children's Hospital of Philadelphia, 
      Philadelphia, Pennsylvania.
FAU - Bezpalko, Orysia
AU  - Bezpalko O
AD  - Performance Improvement, Children's Hospital of Philadelphia, Philadelphia, 
      Pennsylvania.
FAU - Smathers, Sarah A
AU  - Smathers SA
AD  - Infection Prevention and Control, Children's Hospital of Philadelphia, 
      Philadelphia, Pennsylvania.
FAU - Coffin, Susan E
AU  - Coffin SE
AD  - Infectious Disease, Children's Hospital of Philadelphia, Philadelphia, 
      Pennsylvania.
AD  - Perelman School of Medicine, University of Pennsylvania, Philadelphia, 
      Pennsylvania.
FAU - Sammons, Julia S
AU  - Sammons JS
AD  - Infection Prevention and Control, Children's Hospital of Philadelphia, 
      Philadelphia, Pennsylvania.
AD  - Infectious Disease, Children's Hospital of Philadelphia, Philadelphia, 
      Pennsylvania.
AD  - Perelman School of Medicine, University of Pennsylvania, Philadelphia, 
      Pennsylvania.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20180720
PL  - United States
TA  - Infect Control Hosp Epidemiol
JT  - Infection control and hospital epidemiology
JID - 8804099
SB  - IM
MH  - Child, Preschool
MH  - Cross Infection/*prevention & control/virology
MH  - Female
MH  - Gastroenteritis/*epidemiology/virology
MH  - Hospitals, Pediatric/*standards
MH  - Humans
MH  - Infant
MH  - Infection Control/organization & administration
MH  - Male
MH  - Norovirus/isolation & purification
MH  - *Patient Care Bundles
MH  - Philadelphia/epidemiology
MH  - Pneumonia, Viral/epidemiology
MH  - Primary Prevention/organization & administration
MH  - Quality Improvement/organization & administration
MH  - Respiratory Tract Infections/*epidemiology/virology
MH  - Retrospective Studies
MH  - Rhinovirus/isolation & purification
MH  - Seasons
EDAT- 2018/07/22 06:00
MHDA- 2019/07/13 06:00
CRDT- 2018/07/21 06:00
PHST- 2018/07/22 06:00 [pubmed]
PHST- 2019/07/13 06:00 [medline]
PHST- 2018/07/21 06:00 [entrez]
AID - S0899823X18001496 [pii]
AID - 10.1017/ice.2018.149 [doi]
PST - ppublish
SO  - Infect Control Hosp Epidemiol. 2018 Sep;39(9):1086-1092. doi: 
      10.1017/ice.2018.149. Epub 2018 Jul 20.