Paediatric respiratory viral epidemics need not cost the earth

Abstract

Each winter paediatric hospitals worldwide experience increased admissions as a result of respiratory viral epidemics occurring in babies and children who are infected with one or more of eight different viruses. With an escalated number of infected inpatients the risk of healthcare-associated infection (HAI) is increased. Over the past 15 years the number of patients with paediatric viral respiratory infections admitted to a 220-bed Western Australian paediatric hospital has varied between 379 and 870 over a 5-month period. Rates of HAI over this period have ranged from 0.2% to 3.3%.

Successful management of infected patients is dependent upon rapid identification of the causative virus. This enables effective placement of infected patients by single room isolation or cohorting the same infections utilising additional respiratory droplet precautions.

This paper will describe a successful program that is dependent upon: availability of single rooms; an extensive specimen collection service by the virology laboratory; rapid virus detection; testing patients in the emergency department prior to admission; scrupulous attention to hand hygiene by health care workers and visitors; strict attention to decontamination of shared medical equipment; adequate environmental cleaning; effective cough etiquette by health care workers and visitors; and an extensive health care worker influenza vaccination program.

The effectiveness of this management program has been measured by the overall HAI rate of these respiratory viruses. Benchmarking with another larger paediatric hospital has demonstrated a significantly lower HAI and subsequent cost saving with the implementation of this program.