Influenza infection control practices in labor and delivery units during the 2009 H1N1 influenza pandemic

J Obstet Gynecol Neonatal Nurs. 2013 Sep-Oct;42(5):527-40. doi: 10.1111/1552-6909.12243. Epub 2013 Sep 4.

Abstract

Objective: To assess the presence and usefulness of written policies and practices on infection control consistent with the Center for Disease Control and Prevention's (CDC) guidance in hospital labor and delivery (L&D) units during the 2009 H1N1 influenza pandemic.

Setting: Online survey.

Participants: Of 11,845 eligible nurses, 2,641 (22%) participated. This analysis includes a subset of 1,866 nurses who worked exclusively in L&D units.

Methods: A cross-sectional descriptive evaluation was sent to 12,612 members from the Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN) who reported working in labor, delivery, postpartum, or newborn care settings during the 2009 H1N1 influenza pandemic.

Results: Respondents (73.8%) reported that CDC guidance was very useful for infection control in L&D settings during the pandemic. We assessed the presence of the following infection control written policies, consistent with CDC's guidance in hospital L&D units, during the 2009 H1N1 influenza pandemic and their rate of implementation most of the time: questioning women upon arrival about recent flu-like symptoms (89.4%, 89.9%), immediate initiation of antiviral medicines if flu suspected or confirmed (65.2%, 49%), isolating ill women from healthy women immediately (90.7%, 84.7%), ask ill women to wear masks during L&D (67%, 57.7%), immediately separating healthy newborns from ill mothers (50.9%, 42.4%), and bathing healthy infants when stable (58.4%, 56.9%). Reported written policies for five of the six practices increased during the pandemic. Five of six written policies remained above baseline after the pandemic.

Conclusions: Respondents considered CDC guidance very useful. The presence of written policies is important for the implementation of infection control practices by L&D nurses.

Keywords: 2009 H1N1 pandemic; AWHONN; infection control; maternal and infant precautions.

MeSH terms

  • Adult
  • Centers for Disease Control and Prevention, U.S. / standards
  • Cross Infection / epidemiology
  • Cross Infection / prevention & control*
  • Cross-Sectional Studies
  • Delivery Rooms
  • Delivery, Obstetric / standards
  • Female
  • Humans
  • Incidence
  • Infant, Newborn
  • Infection Control / organization & administration*
  • Influenza A Virus, H1N1 Subtype / isolation & purification*
  • Influenza, Human / epidemiology*
  • Influenza, Human / prevention & control
  • Male
  • Neonatal Nursing / organization & administration
  • Nurse's Role
  • Obstetric Nursing / organization & administration
  • Pandemics / prevention & control*
  • Pregnancy
  • Risk Assessment
  • Surveys and Questionnaires
  • United States / epidemiology