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

Healthcare-associated respiratory viral infections (HARVIs) are increasingly recognized as important causes of harm in high-risk children, especially neonates and children with underlying immunosuppression, or chronic cardiac or respiratory conditions. [1] [2] [3] [4] [5] [6] With the implementation of multiplex polymerase chain reaction (PCR) tests capable of detecting multiple respiratory viruses, viruses such as rhinovirus are frequently identified as the cause of clinical deterioration of infants in the neonatal intensive care unit (NICU). 2, [7] [8] [9] [10] Studies have shown HARVIs in the NICU result in escalations of care, prolonged respiratory support, and prolonged hospitalizations. 2, 3, 11 Interventions to prevent the transmission of HARVIs such as influenza vaccination, hand hygiene, standard precautions, transmission-based precautions, and environmental cleaning, have focused primarily on the behavior of healthcare workers (HCWs). 1, 12, 13 Family members and visitors play important roles in the care and well-being of hospitalized children, but unfortunately, they occasionally expose the hospitalized child to viruses. In 1 study, about 30% of children with healthcare-associated viral infections were exposed to an ill caregiver or visitor. 1 In efforts to limit transmission of viral infections, most pediatric hospitals enact some form of visitor restrictions or visitor screening in an attempt to limit the presence of symptomatic persons in the hospital. 14 The scope and implementation of these types of interventions are variable.