Reviewed by Emily Thorell, MD; University of Utah School of Medicine

Visitor restrictions are currently a hot topic in many healthcare settings. Children’s hospitals have long argued that these measures are key in preventing nosocomial transmission in the winter months when the wards are overfilled with children with respiratory viral infections.

Forkpa et al. calculated viral respiratory infection (VRI) transmission indices (accounting for burden of community disease) before and after instituting restrictions for several seasons. Restrictions included limiting the total number of visitors and denying entry to non-sibling children <18 years old, siblings <12 years old, and any person with VRI or gastrointestinal symptoms. Screening was in place in the lobby and performed again by the bedside nurses. Parents with viral respiratory symptoms were allowed to visit but encouraged to wear a surgical mask and practice hand hygiene and respiratory etiquette. The authors found that the healthcare-associated (HA) VRI transmission index (number of HA VRIs per 100 inpatient community-associated VRIs) was 59% lower during the months in which visitor restrictions were implemented. This translated into ~ 5 fewer HA VRIs for every 100 children admitted with a community-associated VRI while visitor restrictions were in place. Interestingly, their data suggested that this was not limited to the winter seasons and could be applicable year-round for other seasonal viruses.

As we all struggle with the best way to keep our patients and caregivers safe from respiratory viral infections, it seems that visitor restrictions may be a useful addition to a bundled approach including influenza vaccination, strict hand hygiene, face coverings, and proper PPE usage.

Reference: 

Forkpa H, Rupp AH, Shulman ST, et al. Association Between Children's Hospital Visitor Restrictions and Healthcare-Associated Viral Respiratory Infections: A Quasi-Experimental Study. J Pediatric Infect Dis Soc. 2020;9(2):240-243. doi:10.1093/jpids/piz023