General influenza infection control policies and practices during the 2009 H1N1 influenza pandemic: a survey of women's health, obstetric, and neonatal nurses.
BACKGROUND
An evaluation of infection control practices was conducted following the release of the Centers for Disease Control and Prevention (CDC) guidance regarding the care of pregnant women during the 2009 H1N1 influenza pandemic. This paper describes 9 general hospital practices.


METHODS
A questionnaire was distributed electronically to 12,612 members of the Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN). Respondents (N = 2,304) who reported working in obstetric or neonatal settings during the pandemic completed the questionnaire.


RESULTS
Most (73%) respondents considered the Centers for Disease Control and Prevention's guidance very useful. Significantly more reported a written hospital policy for each practice during versus before the pandemic. Six of the 9 practices were implemented most of the time by at least 70% of respondents; the practices least often implemented were mandatory vaccination of health care personnel involved (52%) and not involved (34%) in direct patient care and offering vaccination to close contacts of newborns prior to discharge (22%). The most consistent factor associated with implementation was the presence of a written policy supporting the practice at the respondent's hospital.


CONCLUSIONS
We offer a descriptive account of general hospital infection control policies and practices during the 2009 H1N1 pandemic. Factors associated with reported implementation may be useful to inform planning to protect women and children for future public health emergencies.
Independent Research and Evaluation Consultant, Evanston, IL. Electronic address: hruchross@aol.com.
Holly S
HS
Ruch-Ross
Centers for Disease Control and Prevention, Atlanta, GA.
Lauren B
LB
Zapata
Centers for Disease Control and Prevention, Atlanta, GA.
Jennifer L
JL
Williams
Association of Women's Health, Obstetric, and Neonatal Nurses, Washington, DC.
Catherine
C
Ruhl
D002487:Centers for Disease Control and Prevention, U.S. / Q000592:standards; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017053:Infection Control / Q000458:organization & administration*; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D037141:Mandatory Programs; D017283:Neonatal Nursing / Q000706:statistics & numerical data; D009773:Obstetric Nursing / Q000706:statistics & numerical data; D016134:Organizational Policy; D058873:Pandemics / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control* / Q000821:virology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014611:Vaccination; D014789:Visitors to Patients
CDC guidance; H1N1 pandemic; Hospital nursery; Hospital policy and practice; Labor and delivery