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Banning Kids From Hospitals To Reduce Spread Of H1N1 Flu: Where’s The Evidence?

I learned recently that Happy’s hospital was one of a growing number of hospitals nationwide banning children from entry during the pandemic H1N1 flu to protect their patients.  But where is the science that says it works?

Hospitals nationwide are making up their policies as they go along.

The result? Huge variation. The large Stanford University Hospital in California on Monday barred anyone under 16 from visiting, while the small Central Vermont Hospital turned away the under-12 crowd. Other hospitals have settled on 14 or 18.

I’m told that Happy’s hospital set its rules based on the guidance of their infection control specialists.  But where is the evidence that it works?  Say granny comes in with pneumonia and the only daughter, a single mother in town with four children ranging in ages from 2-7 wants to come visit?  Are we going to have security guards tell her no?
Is Happy’s hospital going to have a free 24 hour daycare available to the guests of patients?
What about all the doctors and nurses and cleaning people who have sick kids at home.  Are we going to ban them too because they might get the flu and infect our hospitalized patients?

I looked up the CDC recommendations and as far as I can tell, I couldn’t find any recommendation to ban an entire population from hospital access.   Here is a smallpart of the CDC’s recommendations”

Elimination of potential exposures:  Eliminating the potential source of exposure ranks highest in the hierarchy of controls. Examples of interventions in this category include: taking steps to minimize outpatient visits for patients with mild influenza-like illness who do not have risk factors for complications, postponing elective visits by patients with suspected or confirmed influenza until they are no longer infectious, and denying entry to visitors who are sick.
All people with H1N1 or symptoms of H1N1 should not go to the hospital.  That means whether you are 4 years old or 40 years old you should stay home.  Banning an entire population from seeing their loved ones in the hospital is, in my opinion, absurd.  You might as well ban everyone because most adults come in contact with children at some point in the day.
This policy sounds like a perfect Joint Commission/Medicare National Bank Quality Indicator.  Who needs evidence, right?

*This blog post was originally published at A Happy Hospitalist*


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