Published online April 1, 2005
PEDIATRICS Vol. 115 No. 4 April 2005, pp. e387-e392 (doi:10.1542/peds.2004-2014)
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ELECTRONIC ARTICLE

Infection Control Policies and Hospital-Associated Infections Among Surgical Patients: Variability and Associations in a Multicenter Pediatric Setting

Danielle M. Zerr, MD, MPH*,{ddagger}, Michelle M. Garrison, MPH§, Amanda L. Allpress, BA{ddagger}, Joan Heath, RN, BSN, CIC{ddagger} and Dimitri A. Christakis, MD, MPH*,{ddagger},§

* Department of Pediatrics
§ Child Health Institute, University of Washington, Seattle, Washington
{ddagger} Children's Hospital and Regional Medical Center, Seattle, Washington

Background. Hospital-associated infections are an important cause of patient morbidity and death. Little is known about the variability of infection rates and infection control practices among pediatric hospitals.

Methods. This cross-sectional study was performed with the Pediatric Health Information System database, which includes demographic and diagnostic data for 35 freestanding, noncompeting, children's hospitals, and with data from a survey of the hospitals, which yielded additional information on infection control policies and practices. Patients undergoing elective surgical procedures were included in this study.

Results. Of the 35 eligible hospitals, 31 (89%) chose to participate in the survey component of this study. A total of 48278 patients met the inclusion criteria for the study; 2.3% of these patients had respiratory infections and 0.8% had gastrointestinal infections. The frequency of patients diagnosed with respiratory or gastrointestinal infections varied considerably among the hospitals and ranged from <1% to 6%. Certain infection control processes also varied among the hospitals during the study period. For instance, of the 31 hospitals, 12 monitored hand hygiene, 19 had administrative support of hand hygiene, and 16 had alcohol hand gel present for the entire study period. The presence of alcohol hand gel for the entire study was strongly and independently associated with lower odds of gastrointestinal infections (adjusted odds ratio: 0.64; 95% confidence interval: 0.49-0.85).

Conclusions. Hospitals should support the use of alcohol hand gel, with the aim of decreasing hospital-associated infection rates.

Key Words: infection control • hospital-associated infection • hand hygiene

Abbreviations: ICD-9, International Classification of Diseases, Ninth Revision • PHIS, Pediatric Health Information System • OR, odds ratio • CI, confidence interval • CDC, Centers for Disease Control and Prevention

Accepted Nov 15, 2004.


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