A Hand Hygiene Campaign To Prevent the Transmission of RSV in the Pediatric Intensive Care Unit

ISSUE: Respiratory Syncytial Virus (RSV) is a common cause of bronchiolitis and pneumonia in children. Every “season” we are inundated with RSV admissions and challenged to prevent nosocomial transmission. Historically, our nosocomial transmission rate has been kept to a minimum (0–2 cases/season). However, between August 24 and November 6, 2003, we had three cases of nosocomial acquisition (two cases occurring within 2 days of each other) in our 12-bed pediatric intensive care unit (PICU). PROJECT: Although staff education has been required with the start of every RSV season, this year required additional interventions. A program to increase staff and family awareness was initiated, “Clean hands across the PICU.” This innovative educational tool stressed the importance of frequent and appropriate hand hygiene. Education was provided to staff, family, and visitors by Epidemiology and members of the PICU staff. Posters were displayed, and newly designed handouts were included in every pediatric admission packet. RESULTS: We have received positive feedback from staff and family members and have directly observed an increase in hand hygiene, especially with the alcohol-based product. Two months after this initiative, no additional nosocomial transmission has occurred despite continued RSV admissions (27 cases to date). LESSONS LEARNED: “Clean hands across the PICU” has greatly heightened the awareness of appropriate and frequent hand hygiene for staff and family. It has proven to be an effective means of preventing nosocomial transmission. Because of our success, we have extended this initiative to include our other two pediatric units.