Updated Guidelines for Infection Prevention and Control in Pediatric Ambulatory Care Settings

Target Audience: Pediatric healthcare providers

Background and Objective

In 2007, the AAP released guidelines on infection control and prevention in outpatient settings. This is an update of that document, with specific focus on vaccination and isolation procedures for patients and employees.

What's Changed

• Recommendation for mandatory influenza vaccination for healthcare workers.

• Guidance on infection control practices for children with cystic fibrosis, including recommendation to wear a mask in common areas.

• Recommendation for communication between healthcare facilities when referring a potentially contagious patient.

Key Recommendations

• Practice effective hand hygiene — the most important intervention to ensure infection prevention.

• Implement standard precautions for all patient encounters, including hand hygiene, barrier protection, respiratory hygiene and cough etiquette, and safe handling of sharps. Gloves are not indicated for diaper changes and some body fluid contact (nasal secretions, tears) in a well child, or when administering vaccines, unless contact precautions are required.

• Use 70% isopropyl alcohol for skin antisepsis for immunizations and blood draws.

• Make visual alerts and supplies readily available for compliance with respiratory hygiene.

• Perform regular education of staff regarding OSHA requirements for preventing exposure to bloodborne pathogens.

• Ensure adherence to immunization recommendations for healthcare workers, including mandatory annual influenza vaccine.

• Implement policies to prevent the spread of contagious conditions from infected to uninfected children in common areas.

• Minimize exposure to infections via contaminated fomites by avoiding toys that cannot be cleaned (plush toys), cleaning toys at the end of the day, and encouraging families to bring their own toy or book to visits.