THE SUCCESS & FAILURE OF HANDWASHING AS A METHOD OF INFECTION CONTROL ON A PEDIATRIC SERVICE: A RETROSPECTIVE STUDY

Respiratory Syncytial Virus (RSV) & rotavirus (RO) cause significant illness in infants & toddlers & account for many pediatric winter admissions. Since both viruses are nosocomially spread via personnel, early diagnosis & infection control measures, particularly handwashing, should be effective for control of both diseases. An educational program on RSV disease & epidemiology directed at pediatric personnel, instituted prior to the RSV peak season, appeared to control nosocomial RSV infections. During RSV season 14% of 846 general pediatric admissions were cultured for RSV & 35% of these (N=43) were proven RSV infections. Only 1 was a nosocomially acquired RSV infection. During peak RO season (February-April) which overlapped with the RSV season, 15% of 414 general pediatric admissions were cultured for RO & 61% of these were positive for RO (N=38). In 1 month, 4 of the 7 documented nosocomial RO infections occurred on the general pediatric service. A diaper weighing & disposal problem was identified. After an educational program on RO infections & a new policy for diaper disposal were instituted, the nosocomial infection (NI) rate decreased from 5 NI/17 RO cases to 1 NI/12 RO cases the following month. A pediatric infection control program should include season-specific educational programs, a feedback review system & a policy allowing nursing initiated early isolation of suspected viral illness.