Perspectives of hospital leaders and staff on patient education for the prevention of healthcare-associated infections

2021 ◽  
pp. 1-6
Author(s):  
Sarah R. MacEwan ◽  
Eliza W. Beal ◽  
Alice A. Gaughan ◽  
Cynthia Sieck ◽  
Ann Scheck McAlearney
Keyword(s):  
Patient Education ◽  
Infection Prevention ◽  
Bloodstream Infections ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Central Lines ◽  
Challenges And Opportunities ◽  
Hospital Leaders ◽  
Tract Infections ◽  
Healthcare Associated

Abstract Objective: Device-related healthcare-associated infections (HAIs), such as catheter-associated urinary tract infections (CAUTIs) and central-line–associated bloodstream infections (CLABSIs), are largely preventable. However, there is little evidence of standardized approaches to educate patients about how they can help prevent these infections. We examined the perspectives of hospital leaders and staff about patient education for CAUTI and CLABSI prevention to understand the challenges to patient education and the opportunities for improvement. Methods: In total, 471 interviews were conducted with key informants across 18 hospitals. Interviews were analyzed deductively and inductively to identify themes around the topic of patient education for infection prevention. Results: Participants identified patient education topics specific to CAUTI and CLABSI prevention, including the risks of indwelling urinary catheters and central lines, the necessity of hand hygiene, the importance of maintenance care, and the support to speak up. Challenges, such as lack of standardized education, and opportunities, such as involvement of patient and family advisory groups, were also identified regarding patient education for CAUTI and CLABSI prevention. Conclusions: Hospital leaders and staff identified patient education topics, and ways to deliver this information, that were important in the prevention of CAUTIs and CLABSIs. By identifying both challenges and opportunities related to patient education, our results provide guidance on how patient education for infection prevention can be further improved. Future work should evaluate the implementation of standardized approaches to patient education to better understand the potential impact of these strategies on the reduction of HAIs.

Costs of ambulatory pediatric healthcare-associated infections: Central-line–associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs)

2020 ◽  
Vol 41 (11) ◽  
pp. 1292-1297
Author(s):  
Michael L. Rinke ◽  
Suzette O. Oyeku ◽  
William J. H. Ford ◽  
Moonseong Heo ◽  
Lisa Saiman ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Ambulatory Surgery ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Retrospective Case ◽  
Additional Costs ◽  
Tract Infections ◽  
Healthcare Associated

AbstractObjective:Ambulatory healthcare-associated infections (HAIs) occur frequently in children and are associated with morbidity. Less is known about ambulatory HAI costs. This study estimated additional costs associated with pediatric ambulatory central-line–associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTI), and surgical site infections (SSIs) following ambulatory surgery.Design:Retrospective case-control study.Setting:Four academic medical centers.Patients:Children aged 0–22 years seen between 2010 and 2015 and at risk for HAI as identified by electronic queries.Methods:Chart review adjudicated HAIs. Charges were obtained for patients with HAIs and matched controls 30 days before HAI, on the day of, and 30 days after HAI. Charges were converted to costs and 2015 USD. Mixed-effects linear regression was used to estimate the difference-in-differences of HAI case versus control costs in 2 models: unrecorded charge values considered missing and a sensitivity analysis with unrecorded charge considered $0.Results:Our search identified 177 patients with ambulatory CLABSIs, 53 with ambulatory CAUTIs, and 26 with SSIs following ambulatory surgery who were matched with 382, 110, and 75 controls, respectively. Additional cost associated with an ambulatory CLABSI was $5,684 (95% confidence interval [CI], $1,005–$10,362) and $6,502 (95% CI, $2,261–$10,744) in the 2 models; cost associated with a CAUTI was $6,660 (95% CI, $1,055, $12,145) and $2,661 (95% CI, −$431 to $5,753); cost associated with an SSI following ambulatory surgery at 1 institution only was $6,370 (95% CI, $4,022–$8,719).Conclusions:Ambulatory HAI in pediatric patients are associated with significant additional costs. Further work is needed to reduce ambulatory HAIs.

scholarly journals 593. Burden of Healthcare-Associated Infections among Hospitalized Infants within Community Hospitals

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S279-S280
Author(s):  
Ibukunoluwa C Akinboyo ◽  
Rebecca R Young ◽  
Michael J Smith ◽  
Becky A Smith ◽  
Sarah S Lewis ◽  
...  
Keyword(s):  
Infection Control ◽  
Neonatal Intensive Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
Control Network ◽  
Healthcare Associated Infections ◽  
Community Hospitals ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Abstract Background Healthcare-associated infections (HAI) remain the leading cause of morbidity and mortality among hospitalized children. Within community hospitals with targeted infection prevention efforts, participation in an infection control network has led to significant decreases in device or procedure-related infections among adult patients. The impact of these interventions has not been assessed in pediatric patients admitted to community hospitals. Methods We conducted a retrospective cohort study to describe the burden of HAI among hospitalized infants (< 1 year old) within 53 community hospitals participating in the Duke Infection Control Outreach Network (DICON) from 2013–2018. We determined the frequency of device-related HAI, central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI) and hospital-associated pneumonia or ventilator-associated events (HAP/VAE) using National Healthcare Safety Network (NHSN) definitions; and the burden of HAIs among neonatal intensive care units (NICU) and non-NICU centers. The trend of HAI was analyzed with Spearman’s correlation. Results Thirty hospitals reported 150 HAI among 141 infants over the 6-year period. Median (IQR) time to infection was 10 (4, 20) days after admission. Hospitals with a NICU (15) reported more HAI (median 5, (IQR: 3, 12)) than hospitals without a NICU (median 2 (IQR: 1, 2)) (P = 0.031). CLABSI represented 35% of HAI, HAP/VAE were 23% and CAUTI were 12%. The most frequently isolated primary organism for all HAI was Escherichia coli (22 HAI, 15%) which was also isolated in 39% of CAUTI. Methicillin-resistant and methicillin-susceptible Staphylococcus aureus (S. aureus) were the most commonly isolated organisms among CLABSI (17%) and HAP/VAE (33%). Nine centers with ≥4 years of NICU and Central line (CL) use data reported a median (IQR) rate of 1.2 (0, 2.4) CLABSIs/1,000 central line days. There was no change in median CLABSI rate over time (P = 0.47), Figure 1. Conclusion CLABSI, most commonly caused by S. aureus, represented the majority of HAI reported from hospitalized infants within community hospitals participating in an infection control network. Further research into device utilization practices may inform future interventions to reduce HAI. Disclosures All authors: No reported disclosures.

scholarly journals Targeted Assessment for Prevention Facility Assessments: The Most Common CAUTI and CLABSI Infection Prevention Gaps

2020 ◽  
Vol 41 (S1) ◽  
pp. s4-s5
Author(s):  
Rachel Snyder ◽  
Katelyn White ◽  
Janet Glowicz ◽  
Shannon Novosad ◽  
Elizabeth Soda ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Technical Assistance ◽  
Bloodstream Infections ◽  
Central Line ◽  
Postanesthesia Care Unit ◽  
Central Lines ◽  
Control And Prevention ◽  
Acute Care Facilities ◽  
Tract Infections ◽  
Competency Assessments

Background: The Targeted Assessment for Prevention (TAP) strategy is a quality improvement framework created by the Centers for Disease Control and Prevention (CDC) to facilitate the reduction of healthcare-associated infections (HAIs). TAP facility assessments are a component of the TAP strategy and are completed by staff across the facility to help identify perceptions of and target infection prevention gaps. We have described the gaps most commonly reported by facilities completing TAP facility assessments for catheter-associated urinary tract infections (CAUTIs) and central-line–associated bloodstream infections (CLABSIs). Methods: TAP CAUTI and CLABSI assessments were completed by acute-care facilities across the nation, with CDC technical assistance, from December 2014 to August 2019. Similar questions across 2 versions of CAUTI assessments and 3 versions of CLABSI assessments were combined. Analysis was limited to facilities with ≥10 assessments. Infection prevention gaps were defined as ≥33% respondents answering Unknown, ≥33% respondents answering “no,” or ≥50% of respondents answering “no” and “unknown” or “never” and “rarely” “sometimes” “unknown.” The analysis was completed at the facility level, and the gaps most commonly reported across facilities were identified. Results: In total, 1,942 CAUTI assessments from 42 facilities in 12 states and 1,623 CLABSI assessments from 29 facilities in 11 states were included for analysis. The mean numbers of assessments per facility were 46.2 for CAUTIs and 56.0 for CLABSIs. Across both CAUTIs and CLABSIs, commonly reported perceptions about infection prevention gaps included lack of physician and nurse champions for prevention activities, failure to conduct competency assessments, and inconsistency in select device insertion practices (Fig. 1). For CAUTIs, lack of practices to facilitate timely removal of urinary catheters were also commonly reported, with one-third of facilities reporting inconsistency in use of alerts for catheter removal, 78.6% reporting lack of physician response to these alerts, and 90.5% reporting deficiencies in removing unnecessary catheters in the postanesthesia care unit. For CLABSIs, 79.3% of facilities reported failure to replace central lines within 48 hours after emergent insertion, and 62.1% reported that feedback was not provided to staff on central-line device utilization ratios. Conclusion: For both assessments, absence of CAUTI and CLABSI prevention champions, failure to conduct competency assessments, and inconsistency in performing device insertion practices were commonly reported across facilities. These common gaps have and will continue to inform the development of tools and resources to improve infection prevention practices as well as help to better target the implementation of interventions.Funding: NoneDisclosures: None

scholarly journals Reduction of CLABSI in Telemetry Patients through Limiting Central Line Blood Draw

2021 ◽  
Author(s):  
◽  
Caselyn Lok
Keyword(s):  
Healthcare Providers ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Blood Draw ◽  
Central Lines ◽  
Health Complications ◽  
The Many ◽  
Healthcare Associated

CLABSI is known to be one of the many healthcare-associated infections that has led to an increase in health complications, length of hospital stays, and increased in healthcare cost. There is about 25000 bloodstream infection that occurs annually (Haddadin, Annamaraju, & Regunath, 2020). The PICOT question that guided this project was “How does limiting blood-draw from central venous catheter lines influence the rate of central-line associated bloodstream infections (CLABSI) post-implementation compared to rate of CLABSI pre-implementation after eight weeks?” CLABSI prevention bundles were already being used to guide healthcare providers in handling CVC access. There were 15 scholarly articles that supports the use of bundle programs in CVC access and addressing CLABSI. The reduction in handling and manipulation of the CVC access leads to lesser risks of infection. The intervention in this project is the reduction of the CVC access through the limiting of blood draws from central lines with rare exceptions. CVC is primarily used only for the administration of intravenous fluids, antibiotic, parenteral nutrition, and blood products. The intervention utilized a structured decision-making framework to follow during blood draws to avoid using the central line. The project resulted to a reduction of CLABSI rate from 7.9% pre-implementation rate to 0% post-implementation. The limiting of CVC access led to reduced CLABSI episode in the telemetry unit compared to the national average of 5.94%. The project has proven how the intervention implemented can be used in CLABSI prevention bundles to address healthcare associated infections.

Healthcare-associated infections in the postoperative period after cardiac surgery

2018 ◽  
Vol 14 (1) ◽  
Author(s):  
Edivete Regina Andrioli ◽  
Rubens Andrioli Cavalheiro ◽  
Guilherme Campos Furtado ◽  
Walter José Gomes ◽  
Eduardo Alexandrino Medeiros
Keyword(s):  
Cardiac Surgery ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Independent Variables ◽  
Tract Infections ◽  
Healthcare Associated

Background: This study aimed to determine the incidence of healthcare-associated infections (HAIs) in patients undergoing cardiac surgery, analyzing data and clinical outcomes in patients with and without HAIs. Methods: This was a prospective cohort study involving 293 consecutive adult patients undergoing cardiac surgery between April 2011 and October 2012. Results: Of the 293 patients, 60 (24.9%) developed 73 HAIs: 24 surgical site infections, 24 pneumonias, 14 urinary tract infections (UTIs), and 11 bloodstream infections (BSIs). The incidence of ventilator-associated pneumonia was 14.6 cases/1,000 ventilator-days, whereas that of catheter-associated UTI was 7.15 cases/1,000 catheter-days and that of central line-associated BSI was 4.52 cases/1,000 central line-days. Of the 60 patients with HAIs, 20 (33%) died before postoperative day 90, compared with 18 (7.7%) of the 233 patients without HAIs (P < .001). Independent variables associated with infection were length of hospital stay (OR, 1.04; 95% CI, 1.01-1.06; P = .002), duration of urinary catheter use (OR, 1.19; 95% CI, 1.07-1.13; P = .001), and duration of central line use (OR, 1.07; 95% CI, 1.01-1.13; P = .032). Independent variables associated with mortality were Acute Physiology and Chronic Health Evaluation II score (OR, 1.27; 95% CI 1.14-1.42; P < .001), pneumonia (OR, 11.94; 95% CI, 3.83-37.17; P < .001), UTI (OR, 8.59; 95% CI, 1.91-38.7; P = .005), and BSI (OR, 6.16; 95% CI, 1.08-34.98; P = .040). Conclusion: Among the most important complications after cardiac surgery are HAIs. Patients who experience postoperative infections have increased length of hospital stay and mortality.

The Network Approach for Prevention of Healthcare-Associated Infections: Long-Term Effect of Participation in the Duke Infection Control Outreach Network

2011 ◽  
Vol 32 (4) ◽  
pp. 315-322 ◽  
Author(s):  
Deverick J. Anderson ◽  
Becky A. Miller ◽  
Luke F. Chen ◽  
Linda H. Adcock ◽  
Evelyn Cook ◽  
...  
Keyword(s):  
Infection Control ◽  
Bloodstream Infections ◽  
Central Line ◽  
Incidence Rates ◽  
Healthcare Associated Infections ◽  
Bloodborne Pathogens ◽  
Average Decrease ◽  
Tract Infections ◽  
Healthcare Associated

Objective.To describe the rates of several key outcomes and healthcare-associated infections (HAIs) among hospitals that participated in the Duke Infection Control Outreach Network (DICON).Design and Setting.Prospective, observational cohort study of patients admitted to 24 community hospitals from 2003 through 2009.Methods.The following data were collected and analyzed: incidence of central line-associated bloodstream infections (CLABSIs), ventilator-associated pneumonia (VAP), catheter-associated urinary tract infections (CAUTIs), and HAIs caused by methicillin-resistant Staphylococcus aureus (MRSA); employee exposures to bloodborne pathogens (EBBPs); physician EBBPs; patient-days; central line-days; ventilator-days; and urinary catheter-days. Poisson regression was used to determine whether incidence rates of these HAIs and exposures changed during the first 5 and 7 years of participation in DICON; nonrandom clustering of each outcome was controlled for. Cost saved and lives saved were calculated on the basis of published estimates.Results.In total, we analyzed 6.5 million patient-days, 4,783 EBPPs, 2,948 HAIs due to MRSA, and 2,076 device-related infections. Rates of employee EBBPs, HAIs due to MRSA, and device-related infections decreased significantly during the first 5 years of participation in DICON (P < .05 for all models; average decrease was approximately 50%); in contrast, physician EBBPs remained unchanged. In aggregate, 210 CLABSIs, 312 cases of VAP, 332 CAUTIs, 1,042 HAIs due to MRSA, and 1,016 employee EBBPs were prevented. Each hospital saved approximately $100,000 per year of participation, and collectively the hospitals may have prevented 52-105 deaths from CLABSI or VAP. The 7-year analysis demonstrated that these trends continued with further participation.Conclusions.Hospitals with long-term participation in an infection control network decreased rates of significant HAIs by approximately 50%, decreased costs, and saved lives.

Prevention of healthcare associated infections

2019 ◽  
pp. 233-304 ◽  
Author(s):  
Nizam Damani
Keyword(s):  
Prevention And Control ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Central Line ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
And Control

This chapter provides the most up-to-date advice on infection prevention and control (IPC) of the four most common healthcare-associated infections (HAIs). These are: surgical site infections; infection associated with peripheral IV line/cannula and central line-associated bloodstream infections (CLABSIs); catheter-associated urinary tract infections (CAUTI); and hospital-acquired and ventilator-acquired pneumonias (VAP). The chapter examines and summarizes various key elements and discusses implementation of HAI care bundles and high impact interventions which are necessary to reduce these infections.

scholarly journals Impact of a hospital-wide huddle on device utilisation and infection rates: a community hospital’s journey to zero

2020 ◽  
Vol 21 (6) ◽  
pp. 228-233
Author(s):  
Alfredo J Mena Lora ◽  
Mirza Ali ◽  
Candice Krill ◽  
Sherrie Spencer ◽  
Eden Takhsh ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Cost Savings ◽  
Bloodstream Infections ◽  
Central Line ◽  
Culture Of Safety ◽  
Before And After ◽  
Quasi Experimental ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Background: Device utilisation ratios (DUR) correlate with device-associated complications and rates of infection. We implemented a hospital-wide Daily Interdisciplinary Safety Huddle (DISH) with infection control and device components. The aim of this study was to evaluate the impact of DISH on DURs and rates of infection for indwelling urinary catheters (IUC) and central venous catheters (CVC). Methods: A quasi-experimental study assessing DURs and rates of infection before and after implementation of DISH. At DISH, usage of IUC and CVC is reported by managers and the infection preventionist reviews indications and plans for removal. Data before and after implementation were compared. Paired T-test was used to assess for differences between both groups. Results: DISH was successfully implemented at a community hospital. The average DUR for IUC in intensive care unit (ICU) and non-ICU settings was reduced from 0.56 to 0.35 and 0.27 to 0.12, respectively. CVC DUR decreased from 0.29 to 0.26 in the ICU and 0.14 to 0.12 in non-ICU settings. Catheter-associated urinary tract infections (CAUTIs) decreased by 87% and central line-associated bloodstream infections (CLABSIs) by 96%. Conclusion: DISH was associated with hospital-wide reductions in DUR and device-associated healthcare-associated infections. Reduction of CLABSIs and CAUTIs had estimated cost savings of $688,050. The impact was more profound in non-ICU settings. To our knowledge, an infection prevention hospital-wide safety huddle has not been reported in the literature. DISH increased device removal, accountability and promoted a culture of safety.

scholarly journals Pathogens Associated With Repeat Versus Single Central-Line–Associated Bloodstream Infections, Acute-Care Hospitals, NHSN

2020 ◽  
Vol 41 (S1) ◽  
pp. s343-s344
Author(s):  
Margaret A. Dudeck ◽  
Katherine Allen-Bridson ◽  
Jonathan R. Edwards
Keyword(s):  
Acute Care ◽  
National Level ◽  
Bloodstream Infections ◽  
Acute Care Hospitals ◽  
Central Line ◽  
Patient Specific ◽  
Healthcare Associated Infections ◽  
Healthcare Associated ◽  
Repeat Infection ◽  
Single Versus

Background: The NHSN is the nation’s largest surveillance system for healthcare-associated infections. Since 2011, acute-care hospitals (ACHs) have been required to report intensive care unit (ICU) central-line–associated bloodstream infections (CLABSIs) to the NHSN pursuant to CMS requirements. In 2015, this requirement included general medical, surgical, and medical-surgical wards. Also in 2015, the NHSN implemented a repeat infection timeframe (RIT) that required repeat CLABSIs, in the same patient and admission, to be excluded if onset was within 14 days. This analysis is the first at the national level to describe repeat CLABSIs. Methods: Index CLABSIs reported in ACH ICUs and select wards during 2015–2108 were included, in addition to repeat CLABSIs occurring at any location during the same period. CLABSIs were stratified into 2 groups: single and repeat CLABSIs. The repeat CLABSI group included the index CLABSI and subsequent CLABSI(s) reported for the same patient. Up to 5 CLABSIs were included for a single patient. Pathogen analyses were limited to the first pathogen reported for each CLABSI, which is considered to be the most important cause of the event. Likelihood ratio χ2 tests were used to determine differences in proportions. Results: Of the 70,214 CLABSIs reported, 5,983 (8.5%) were repeat CLABSIs. Of 3,264 nonindex CLABSIs, 425 (13%) were identified in non-ICU or non-select ward locations. Staphylococcus aureus was the most common pathogen in both the single and repeat CLABSI groups (14.2% and 12%, respectively) (Fig. 1). Compared to all other pathogens, CLABSIs reported with Candida spp were less likely in a repeat CLABSI event than in a single CLABSI event (P < .0001). Insertion-related organisms were more likely to be associated with single CLABSIs than repeat CLABSIs (P < .0001) (Fig. 2). Alternatively, Enterococcus spp or Klebsiella pneumoniae and K. oxytoca were more likely to be associated with repeat CLABSIs than single CLABSIs (P < .0001). Conclusions: This analysis highlights differences in the aggregate pathogen distributions comparing single versus repeat CLABSIs. Assessing the pathogens associated with repeat CLABSIs may offer another way to assess the success of CLABSI prevention efforts (eg, clean insertion practices). Pathogens such as Enterococcus spp and Klebsiella spp demonstrate a greater association with repeat CLABSIs. Thus, instituting prevention efforts focused on these organisms may warrant greater attention and could impact the likelihood of repeat CLABSIs. Additional analysis of patient-specific pathogens identified in the repeat CLABSI group may yield further clarification.Funding: NoneDisclosures: None

scholarly journals Effect of Removing Contact Precautions for Multidrug-Resistant Organisms on Hospital Infections in a Pediatric Health System

2020 ◽  
Vol 41 (S1) ◽  
pp. s199-s200
Author(s):  
Matthew Linam ◽  
Dorian Hoskins ◽  
Preeti Jaggi ◽  
Mark Gonzalez ◽  
Renee Watson ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Antibiotic Stewardship ◽  
Infection Prevention ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
Contact Precautions ◽  
Stewardship Program ◽  
Tract Infections ◽  
The Impact

Background: Discontinuation of contact precautions for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) have failed to show an increase in associated transmission or infections in adult healthcare settings. Pediatric experience is limited. Objective: We evaluated the impact of discontinuing contact precautions for MRSA, VRE, and extended-spectrum β-lactamase–producing gram-negative bacilli (ESBLs) on device-associated healthcare-associated infections (HAIs). Methods: In October 2018, contact precautions were discontinued for children with MRSA, VRE, and ESBLs in a large, tertiary-care pediatric healthcare system comprising 2 hospitals and 620 beds. Coincident interventions that potentially reduced HAIs included blood culture diagnostic stewardship (June 2018), a hand hygiene education initiative (July 2018), a handshake antibiotic stewardship program (December 2018) and multidisciplinary infection prevention rounding in the intensive care units (November 2018). Compliance with hand hygiene and HAI prevention bundles were monitored. Device-associated HAIs were identified using standard definitions. Annotated run charts were used to track the impact of interventions on changes in device-associated HAIs over time. Results: Average hand hygiene compliance was 91%. Compliance with HAI prevention bundles was 81% for ventilator-associated pneumonias, 90% for catheter-associated urinary tract infections, and 97% for central-line–associated bloodstream infections. Overall, device-associated HAIs decreased from 6.04 per 10,000 patient days to 3.25 per 10,000 patient days after October 2018 (Fig. 1). Prior to October 2018, MRSA, VRE and ESBLs accounted for 10% of device-associated HAIs. This rate decreased to 5% after October 2018. The decrease in HAIs was likely related to interventions such as infection prevention rounds and handshake stewardship. Conclusions: Discontinuation of contact precautions for children with MRSA, VRE, and ESBLs were not associated with increased device-associated HAIs, and such discontinuation is likely safe in the setting of robust infection prevention and antibiotic stewardship programs.Funding: NoneDisclosures: None

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