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Infection Control Assessment after an Influenza Outbreak in a Residential Care Facility for Children and Young Adults with Neurologic and Neurodevelopmental Conditions

Published online by Cambridge University Press:  02 January 2015

Alejandro Azofeifa ,
Lorraine F. Yeung ,
Georgina Peacock ,
Cynthia A. Moore ,
Loren Rodgers ,
Mary DiOrio ,
Shannon L. Page ,
Brian Fowler ,
Nimalie D. Stone  and
Lyn Finelli
...Show all authors
Alejandro Azofeifa*
Affiliation:
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
Lorraine F. Yeung
Affiliation:
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
Georgina Peacock
Affiliation:
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
Cynthia A. Moore
Affiliation:
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
Loren Rodgers
Affiliation:
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia Ohio Department of Health, Columbus, Ohio
Mary DiOrio
Affiliation:
Ohio Department of Health, Columbus, Ohio
Shannon L. Page
Affiliation:
Ohio Department of Health, Columbus, Ohio
Brian Fowler
Affiliation:
Ohio Department of Health, Columbus, Ohio
Nimalie D. Stone
Affiliation:
National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Lyn Finelli
Affiliation:
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Michael A. Jhung
Affiliation:
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
*
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-86, Atlanta, GA 30333 (aazofeifa@cdc.gov).
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Abstract

Objective.

To assess the knowledge, attitudes, and practices of infection control among staff in a residential care facility for children and young adults with neurologic and neurodevelopmental conditions.

Design.

Self-administered survey.

Setting.

Residential care facility (facility A).

Participants.

Facility A staff (N = 200).

Methods.

We distributed a survey to staff at facility A. We classified staff with direct care responsibilities as clinical (ie, physicians, nurses, and therapists) or nonclinical (ie, habilitation assistants, volunteers, and teachers) and used X2 tests to measure differences between staff agreement to questions.

Results.

Of 248 surveys distributed, 200 (81%) were completed; median respondent age was 36 years; 85% were female; and 151 were direct care staff (50 clinical, 101 nonclinical). Among direct care staff respondents, 86% agreed they could identify residents with respiratory symptoms, 70% stayed home from work when ill with respiratory infection, 64% agreed that facility administration encouraged them to stay home when ill with respiratory infection, and 72% reported that ill residents with respiratory infections were separated from well residents. Clinical and nonclinical staff differed in agreement about using waterless hand gel as a substitute for handwashing (96% vs 78%; P = .005) and whether handwashing was done after touching residents (92% vs 75%; P = .04).

Conclusions.

Respondents' knowledge, attitudes, and practices regarding infection control could be improved, especially among nonclinical staff. Facilities caring for children and young adults with neurologic and neurodevelopmental conditions should encourage adherence to infection control best practices among all staff having direct contact with residents.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 7 , July 2013 , pp. 717 - 722
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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References

1.Cox, CM, Blanton, L, Dhara, R, Brammer, L, Finelli, L. 2009 Pandemic influenza A (H1N1) deaths among children–United States, 2009–2010. Clin Infect Dis 2011;52(suppl 1):S69–S74.Google Scholar
2.Keren, R, Zaoutis, TE, Bridges, CB, et al. Neurological and neuromuscular disease as a risk factor for respiratory failure in children hospitalized with influenza infection. JAMA 2005;294(17):2188–2194.Google Scholar
3.Bhat, N, Wright, JG, Broder, KR, et al. Influenza-associated deaths among children in the United States, 2003-2004. N Engl J Med 2005;353(24):2559–2567.CrossRefGoogle ScholarPubMed
4.Centers for Disease Control and Prevention. Severe influenza among children and young adults with neurologic and neuro-developmental conditions—Ohio, 2011. MMWR Morb Mortal Wkly Rep 2012;60:1729–1733.Google Scholar
5.Blanton, L, Peacock, G, Cox, C, Jhung, M, Finelli, L, Moore, C. Neurologic disorders among pediatric deaths associated with the 2009 pandemic influenza. Pediatrics 2012;130(3):390–396.Google Scholar
6.Harper, SA, Bradley, JS, Englund, JA, et al. Seasonal influenza in adults and children—diagnosis, treatment, chemoprophylaxis, and institutional outbreak management: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis 2009;48(8):1003–1032.Google Scholar
7.Arden, NH. Control of influenza in the long-term-care facility: a review of established approaches and newer options. Infect Control Hosp Epidemiol 2000;21(1):59–64.Google Scholar
8.Centers for Disease Control and Prevention. Outbreaks of 2009 pandemic influenza A (H1N1) among long-term-care facility residents-three states, 2009. MMWR Morb Mortal Wkly Rep 2010;59(3):74–77.Google Scholar
9. Centers for Disease Control and Prevention (CDC). Interim Guidance for Influenza Outbreak Management in Long-Term Care Facilities. Atlanta: CDC, 2011. http://www.cdc.gov/flu/professionals/infectioncontrol/ltc-facility-guidance.htm. Accessed November 1, 2012.Google Scholar
10.Ashraf, MS, Hussain, SW, Agarwal, N, et al. Hand hygiene in long-term care facilities: a multicenter study of knowledge, attitudes, practices, and barriers. Infect Control Hosp Epidemiol 2010;31(7):758–762.Google Scholar
11.Mody, L, McNeil, SA, Sun, R, Bradley, SE, Kauffman, CA. Introduction of a waterless alcohol-based hand rub in a long-term-care facility. Infect Control Hosp Epidemiol 2003;24(3):165–171.Google Scholar
12.Aiello, AE, Malinis, M, Knapp, JK, Mody, L. The influence of knowledge, perceptions, and beliefs, on hand hygiene practices in nursing homes. Am J Infect Control 2009;37(2): 164–167.Google Scholar
13.Alvaran, MS, Butz, A, Larson, E. Opinions, knowledge, and self-reported practices related to infection control among nursing personnel in long-term care settings. Am J Infect Control 1994;22(6):367–370.CrossRefGoogle ScholarPubMed
14.Boyce, JM, Pittet, D. Guideline for hand hygiene in health-care settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America/Association for Professionals in Infection Control/Infectious Diseases Society of America. MMWR Recomm Rep 2002;51(16):1–45.Google Scholar
15.US Department of Health and Human Services (HHS). Long-Term Care and Other Residential Facilities Pandemic Influenza Planning Checklist. Washington, DC: HHS, 2012. http://www.flu.gov/planning-preparedness/hospital/longtermcare.pdf. Accessed November 1, 2012.Google Scholar
16.Bridges, CB, Kuehnert, MJ, Hall, CB. Transmission of influenza: implications for control in health care settings. Clin Infect Dis 2003;37(8):1094–1101.Google ScholarPubMed
17.Centers for Disease Control and Prevention (CDC). Prevention Strategies for Seasonal Influenza in Healthcare Settings: Guidelines and Recommendations. Atlanta: CDC, 2010. http://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm. Accessed November 1, 2012.Google Scholar
18.Pittet, D, Allegranzi, B, Sax, Het al. Evidence-based model for hand transmission during patient care and the role of improved practices. Lancet 2006;6(10):641–652.Google Scholar