Infection Control & Hospital Epidemiology Table 1. Multimodal Intervention Program
Hospital-wide Interventions Rhode Island Hospital/Hasbro Children’s Hospital
At time of hospital admission, screen patients with signs/symptoms suggestive of respiratory viral infection using nasopharyngeal swabs; if necessary, cohort patients in same room that have the same respiratory virus
Kiosks at hospital entry sites with: cough etiquette poster; alcohol-based hand hygiene dispenser; facial tissues; masks during respiratory virus season (October–April)
Influenza vaccination of staff required by November 30 (unless a valid medical exemption certification is presented); unvaccinated staff wear masks for patient contact when influenza at CDC-defined widespread level in Rhode Island
Contact and droplet isolation for all patients with suspected or confirmed respiratory viral infection
Disallow Hasbro Children’s Hospital visitors < 12 years of age during respiratory virus season (October–April)
Patient care unit–specific interventions Screen visitors on selected patient care units during respiratory virus season (October–April)
Start Dates
RVP October 2009–July 2017 Mean turnaround, 26.6 h; median, 25.6 ha RPP September 2017–present Mean turnaround, 3.2 h; median, 3.0 ha
September 2010 October 2012 November 2015 January 2017 Hasbro Children’s Hospital
- PICU January 2017 - All other children’s hospital units October 2017
Adult hospital - hematology/oncology and solid-organ transplant units November 2017
- Cardiothoracic ICU January 2018 - Respiratory ICU June 2018 - Medical ICU March 2018
Note. RVP, respiratory virus panel; RPP, respiratory pathogen panel (see Methods section for viruses included in both panels). aTurnaround times (ie, time from NP swab of patient to time results reported in electronic medical record) were measured January 1–10, 2017 and 2018 for RVP and RPP, respectively.
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Table 2. Impact of Visitor Screening on Incidence of Hospital-Acquired Respiratory Viral Infections
Hospital-Acquired Respiratory Viral Infections per 1,000 Patient Care Unit Discharges
Cases Total cases
Visitor screening was not done on patient care unit during 2017–2018 respiratory virus season
Visitor screening was done on patient care unit during 2017–2018 respiratory virus season
Definite cases
Visitor screening was not done on patient care unit during 2017–2018 respiratory virus season
Visitor screening was done on patient care unit during 2017–2018 respiratory virus season
Possible cases
Visitor screening was not done on patient care unit during 2017–2018 respiratory virus season
Visitor screening was done on patient care unit during 2017–2018 respiratory virus season
0.2 0.7 0.4 2.2 2.0 3.1 .26
aVisitor screening was not done during the October 2016–April 2017 respiratory virus season. bHand hygiene compliance in patient care units with no visitor screening and with visitor screening was 82%and91% respectively (P=.001); compliance with isolation precautions was 72%and
60%, respectively (P = .60). cHand hygiene compliance in patient care units with no visitor screening and with visitor screening was 87% and 96% respectively (P < .002); compliance rates with isolation precautions were
89% and 90%, respectively (P = 1.0). d5 coronavirus, 4 influenza, 2 RSV, 2 metapneumovirus, 2 parainfluenza, and 2 rhinovirus/enterovirus. e19 influenza, 10 rhinovirus/enterovirus, 5 metapneumovirus, 4 RSV, 4 viral coinfection, 2 adenovirus, 1 coronavirus, and 2 parainfluenza. f5 RSV, 4 influenza, 2 coronavirus, and 2 enterovirus/rhinovirus. g5 enterovirus/rhinovirus, 5 viral co-infection, 4 RSV, 4 influenza, 1 parainfluenza, 1 metapneumovirus, 1 coronavirus, and 1 adenovirus.
0.7 2.4 2.2 3.1 3.1 1.3 .11 0.9d 3.2f 2.6e 5.3g 2.9 1.7 .67 Oct 2016–Apr 2017a,b Oct 2017–Apr 2018c Rate Ratio P Value
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