Reducing infection transmission in the playroom: Balancing patient safety and family-centered care.
BACKGROUND
Family-centered care requires that institutions develop strategies to allow sibling visitors to hospitalized children while reducing risks of infectious disease transmission. Most guidelines recommend that siblings not be permitted to visit playrooms. This approach was not seen as consistent with family-centered care in our setting; therefore, in a pilot project we developed an approach for screening siblings with cooperation of families, child life specialists, the care team, and the infection prevention and control service.


METHODS
A literature review using CINAHL and PubMed databases (Medical Subject Heading terms: visitors to patients, child, infection, nosocomial, and siblings) from 2004-2014 did not uncover formal established methods for reducing playroom infectious disease exposures. Benchmarking with other Canadian centers revealed a diversity of approaches. Child life, the ward staff, and infection prevention and control at this center collaborated to develop a sibling screening strategy.


RESULTS
The collaborative approach led to a process based on a screening form that is introduced to the family during admission. The process requires the cooperation of the admitting nurse, parents, and child life staff. In the first 2 years of the project, approximately 10% of screened siblings had a potentially communicable illness.


CONCLUSIONS
A collaborative multidisciplinary approach based on family center care principles led to a process whereby siblings of hospitalized children can be allowed to visit playrooms, while reducing risk of infectious disease transmission.
Infection Prevention and Control Services, Dalhousie University, Halifax, NS, Canada.
Allana
A
Ivany
Child Life Services, IWK Health Centre, Dalhousie University, Halifax, NS, Canada.
Chantal
C
LeBlanc
Dalhousie University, Halifax, NS, Canada.
Mackenzie
M
Grisdale
Infection Prevention and Control Services, Dalhousie University, Halifax, NS, Canada.
Bridget
B
Maxwell
Infection Prevention and Control Services, Dalhousie University, Halifax, NS, Canada; Child Life Services, IWK Health Centre, Dalhousie University, Halifax, NS, Canada; Departments of Pediatrics and Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada. Electronic address: joanne.langley@dal.ca.
Joanne M
JM
Langley
D019985:Benchmarking; D002170:Canada; D002648:Child; D002675:Child, Preschool; D003299:Cooperative Behavior; D003428:Cross Infection / Q000517:prevention & control* / Q000635:transmission; D006306:Health Surveys / Q000379:methods*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010290:Parents; D061214:Patient Safety; D010865:Pilot Projects; D010988:Play and Playthings; D012306:Risk; D035781:Siblings; D062606:Tertiary Care Centers; D014789:Visitors to Patients
Child; Family-centered nursing; Nosocomial; Play; Visitors to patients