Skip to main content Accessibility help

Visitor restriction policies and practices in children’s hospitals in North America: results of an Emerging Infections Network Survey

  • Alice L. Pong (a1) (a2), Susan E. Beekmann (a3), Mekleet M. Faltamo (a4), Philip M. Polgreen (a3) (a5) and Andi L. Shane (a6) (a7)...



To delineate the timing of, indications for, and assessment of visitor restriction policies and practices (VRPP) in pediatric facilities.


An electronic survey to characterize VRPP in pediatric healthcare facilities.


The Infectious Diseases Society of America Emerging Infections Network surveyed 334 pediatric infectious disease consultants via an electronic link. Descriptive analyses were performed.


A total of 170 eligible respondents completed a survey between 12 July and August 15, 2016, for a 51% response rate. Of the 104 respondents (61%) familiar with their VRPP, 92 (88%) had VRPP in all inpatient units. The respondents reported age-based VRPP (74%) symptom-based VRPP (97%), and outbreak-specific VRPP (75%). Symptom-based VRPP were reported to be seasonal by 24% of respondents and to be implemented year-round according to 70% of respondents. According to the respondents, communication of VRPP to families occurred at admission (87%) and through signage in care areas (64%), while communication of VRPP to staff occurred by email (77%), by meetings (55%), and by signage in staff-only areas (49%). Respondents reported that enforcement of VRPP was the responsibility of nursing (80%), registration clerks (58%), unit clerks (53%), the infection prevention team (31%), or clinicians 16 (16%). They also reported that the effectiveness of VRPP was assessed through active surveillance of hospital acquired respiratory infections (62%), through active surveillance of healthcare worker exposures (28%) and through patient/family satisfaction assessments (29%).


Visitor restriction policies and practices vary in scope, implementation, enforcement, and physician awareness in pediatric facilities. A prospective multisite evaluation of outcomes would facilitate the adoption of uniform guidance.


Corresponding author

Author for correspondence: Alice Pong, MD, 3020 Children’s Way, MC 5041, San Diego, CA 92123. E-mail:


Hide All
1. Hansen, S, Stamm-Balderjahn, S, Zuschneid, I, et al. Closure of medical departments during nosocomial outbreaks: data from a systematic analysis of the literature. J Hosp Infect 2007;65:348353.
2. Halasa, NB, Williams, JV, Wilson, GJ, Walsh, WF, Schaffner, W, Wright, PF. Medical and economic impact of a respiratory syncytial virus outbreak in a neonatal intensive care unit. Pediatr Infect Dis J 2005;24:10401044.
3. Ehlken, B, Ihorst, G, Lippert, B, et al. Economic impact of community-acquired and nosocomial lower respiratory tract infections in young children in Germany. Eur J Pediatr 2005;164:607615.
4. Macartney, KK, Gorelick, MH, Manning, ML, Hodinka, RL, Bell, LM. Nosocomial respiratory syncytial virus infections: the cost-effectiveness and cost-benefit of infection control. Pediatrics 2000;106:520526.
5. Dare, RK, Talbot, TR. Health care-acquired viral respiratory diseases. Infect Dis Clin North Am 2016;30:10531070.
6. Hall, CB. Nosocomial respiratory syncytial virus infections: the “Cold War” has not ended. Clin Infect Dis 2000;31:590596.
7. Kuo, DZ, Houtrow, AJ, Arango, P, Kuhlthau, KA, Simmons, JM, Neff, JM. Family-centered care: current applications and future directions in pediatric health care. Matern Child Health J 2012;16:297305.
8. Rozdilsky, JR. Enhancing sibling presence in pediatric ICU. Crit Care Nurs Clin North Am 2005;17:451461, xii.
9. Shuler, SN, Reich, CA. Sibling visitation in pediatric hospitals: policies, opinions, and issues. Child Health Care 1983;11:5460.
10. Garcia, R, Raad, I, Abi-Said, D, et al. Nosocomial respiratory syncytial virus infections: prevention and control in bone marrow transplant patients. Infect Control Hosp Epidemiol 1997;18:412416.
11. Snydman, DR, Greer, C, Meissner, HC, McIntosh, K. Prevention of nosocomial transmission of respiratory syncytial virus in a newborn nursery. Infect Control Hosp Epidemiol 1988;9:105108.
12. Siegel, JD, Rhinehart, E, Jackson, M, Chiarello, L. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control 2007;35:S65S164.
13. Pillai, SK, Beekmann, SE, Santibanez, S, Polgreen, PM. The Infectious Diseases Society of America emerging infections network: bridging the gap between clinical infectious diseases and public health. Clin Infect Dis 2014;58:991996.
14. Liu, V, Read, JL, Scruth, E, Cheng, E. Visitation policies and practices in US ICUs. Crit Care 2013;17:R71.
15. Washam, M, Woltmann, J, Ankrum, A, Connelly, B. Association of visitation policy and health care-acquired respiratory viral infections in hospitalized children. Am J Infect Control 2018;46:353355.


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed