The effectiveness of infection control measures during a Rotavirus outbreak in a 36-bed pediatric progressive care unit

ISSUE: Low compliance in following established infection control measures; such as hand hygiene and isolation precautions by healthcare workers can result in an outbreak of Rotavirus in a pediatric progressive care unit (PCU). PROJECT: Staff compliance with the established infection control measures was found to be low during the weekly inspections by the infection control practitioner (ICP) in the year preceding the outbreak. During that same time period, quarterly inservices had been presented by the ICP reinforcing the importance of sound infection control practices, but the compliance rates continued to remain low. During the winter an outbreak of healthcare-associated Rotavirus was detected in PCU. At the beginning of the outbreak, lectures regarding infection control practices were presented to limited numbers of staff but new cases of Rotavirus continued to occur. Another series of mandatory interactive inservices were presented by the ICP, and these were attended by a majority of the unit clinical staff. The staff agreed to be proactive in controlling the outbreak by intervening, teaching, and observing their coworkersʹ compliance with infection control measures. Alcohol foam dispensers were installed inside and outside every patientʹs room and pocket-size alcohol hand products were made available for the staff. All patients with diarrhea were placed on contact precautions with ample supplies of gowns and gloves outside every patientʹs room. RESULTS: Staff adherence to established infection control practices was noted during infection control rounds. The outbreak of Rotavirus was brought under control within 2 weeks and no additional healthcare-associated cases were identified after that time. LESSONS LEARNED: 1) Education alone did not have a strong impact in controlling this outbreak. 2) The teamwork approach of self-monitoring compliance prevented the continuance of this outbreak. 3) Increased availability of alcohol foam dispensers increased hand hygiene compliance. 4) Timely initiation of isolation played an important role in controlling this particular outbreak.