ISR 12 - Impact to Healthcare Associated Respiratory Viral Rates Before, During and After the COVID-19 Pandemic in a Freestanding Children’s Hospital

Monday, June 3, 2024

4:41 PM – 5:00 PM CST

Location: Room 214 AB

Presenter(s)

Kellie Rusin, MPH, MLS (ASCP)CM, CIC

Infection Preventionist
Children's Hospital Colorado
Denver, Colorado

PDF

Co-Author(s)

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Sara Saporta-Keating, MS, MD

Assistant Professor of Pediatrics and Epidemiology Associate Medical Director
Department of Pediatrics, University of Colorado, Children's Hospital Colorado
Samuel R. Dominguez, MD, PhD

Professor,CU School of Medicine, Medical Director Children's Hospital Colorado Clinical Microbiology
Department of Pediatrics, University of Colorado, Children's Hospital Colorado
Ann-Christine Nyquist, MD, MSPH

Chief Epidemiology Officer
Department of Pediatrics, University of Colorado, Children's Hospital Colorado
Aurora, Colorado
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Kelly Pearce, BA

Data Analytics & Reporting Analyst Professional
Children's Hospital Colorado
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Lori Silveira, PhD

Assistant Professor, Pediatrics University of Colorado
Department of Pediatrics, School of Medicine, University of Colorado

Moderator(s)

Robert P. Thornhill, MSN, RN, CIC

Infection Prevention Manager
Baptist Health System
New Braunfels , Texas

Disclosure(s):

Kellie Rusin, MPH, MLS (ASCP)CM, CIC: No financial relationships to disclose

Sara Saporta-Keating, MS, MD: No relevant disclosure to display

Samuel R. Dominguez, MD, PhD: No relevant disclosure to display

Ann-Christine Nyquist, MD, MSPH: No financial relationships to disclose

Kelly Pearce, BA: No financial relationships to disclose

Lori Silveira, PhD: No financial relationships to disclose

Robert P. Thornhill, MSN, RN, CIC: No financial relationships to disclose

Background: Healthcare associated respiratory viral infections (HA-RVI) can increase morbidity and mortality as well as length of stay in vulnerable pediatric populations. Reducing the incidence of HA-RVIs is a challenge, particularly in pediatrics where the developmental needs of patients and the need for caregivers to be present must be considered. During the COVID-19 pandemic our hospital implemented enhanced infection prevention measures, including universal masking and visitation restrictions. Accordingly, this afforded the opportunity to determine the impact these measures had on HA-RVI rates.

Methods: HA-RVI was defined as any hospitalized patient with a new positive respiratory virus test and upper respiratory tract infection symptoms. Monthly HA-RVI rates were calculated as the number of HA-RVI per 10,000 patient days. HA-RVI rates from three different intervention periods were compared: (1) pre-COVID-19, annual restrictions prohibiting visitors under the age of 13 during respiratory viral season, (2) COVID-19 pandemic period, visitation restricted to 2 adults and implementation of universal masking, and (3) when COVID-19 was at regionally low rates a 10-person approved visitor list inclusive of siblings of any age was implemented, but universal masking was continued.

Results: There was a mean of 10.4 HA-RVIs per 10,000 patient days per month during the pre-COVID timeframe compared to 5.2 during the initial more restricted COVID period and 8.6 during the 3rd period, with relaxation of visitor restrictions but continued masking requirements. Comparisons between times periods 1 and 2 and time periods 2 and 3 were statistically significant (p-value = < 0.001).

Conclusions: Our data demonstrate the positive impact universal mask use and visitor restrictions can have on HA-RVIs. Universal masking and limitation to 2 visitors was most effective at reducing our HA-RVIs. Further study is warranted to understand if visitor restrictions alone can be effective in reducing HA-RVIs, or if universal masking is an essential infection control adjunct during respiratory season.

Learning Objectives:

Upon completion, the participant will be able to describe the impact visitation can have to healthcare associated respiratory viral rates in a freestanding children's hospital.
Upon completion, the participant will be able to describe different visitation restriction strategies used during respiratory viral season before, during and after and COVID-10 pandemic.
Upon completion, the participant will be able to list visitation restriction variations that can reduce the risk of healthcare associated respiratory viral rates.