Key Points
Î Given the limited scientific evidence on the subject, studies designed to
evaluate the role of visitors in the horizontal transmission of pathogens
should be performed.
Î Until the appropriate studies are performed, the use of isolation
precautions among visitors should be guided by the specific pathogen, the
underlying infectious condition, and the endemicity of the organism in both
the hospital and the surrounding community.
Î These recommendations should be adapted to individual hospital needs
and patient populations. Additionally, hospitals should consider writing
policies regarding visitors only when they can be realistically enforced
and regularly evaluated for compliance. Resources should be allocated to
hospital infection prevention programs to develop infrastructure to scale up
visitor-related infection control policy enforcement in settings of heightened
horizontal transmission.
Î All visitors should perform hand hygiene prior to entering a patient room and
immediately after leaving the room.
Notes:
▶ Either hand washing with soap or water and proper use of an alcohol-based hand rub are
acceptable means of hand hygiene.
▶ Institutions should ensure that sinks and alcohol-based hand rub stations are easily accessible
to visitors.
▶ Visitors should be educated on the importance of frequent hand hygiene in the hospital setting
and on the available options and proper techniques for performing hand hygiene.
Î For parents/guardians/visitors with extended stay in a patient's room
including overnight visitation, isolation precautions may not be practical.
The risk of infection for parents/guardians/visitors is likely reduced if they
practice good hand hygiene and any additional benefit of wearing gowns and
gloves in these scenarios of prolonged exposure is unclear.
Î In special situations, in which patients acquire new transmissible infections
after admission to the hospital, protection of parent/guardian/visitor by the
use of isolation precautions may be considered.
Notes:
▶ Examples of such scenarios could include parents of children with hospital onset of C. difficile
infection or colonization/infection with extensively antibiotic-resistant Gram negative bacilli
(e.g. Klebsiella pneumoniae carbapenemase [KPC]).
▶ If parents or other visitors are assisting health care personnel (HCP) with providing care,
standard precautions should be utilized, including the use of gowns and gloves, if contact with
blood, body fluids, or non-intact skin is anticipated.
Recommendations
