Abstract Rationale Environmental sustainability is a priority for intensive care units. Single-use supplies contribute to healthcare waste, which is amplified when unused supplies are discarded. Due to an inability to disinfect paper, our infection prevention and control (IPC) team mandated that unopened sterile single-use supplies stored in bedside supply carts with any component of paper packaging be discarded between patient admissions to the pediatric intensive care unit (PICU) (hereafter ‘the IPC practice’). Study objectives were to determine opinions about this mandated IPC practice, including what evidence should be required to implement the practice, and what evidence would be adequate to abandon the practice. This was the first survey we are aware of that asked healthcare workers to consider the IPC practice in PICU. Methods A validated and pilot tested survey was distributed to pediatric intensivists engaged in multicenter research in Canada, and all PICU nurses at one institution in Canada. Results The survey response rate was 75/254 (30%); 17/45 (38%) for intensivists and 58/209 (28%) for nurses. Ten (13%) respondents agreed the practice would be effective in preventing nosocomial infections. Few participants agreed that the IPC practice is based on empirical data regarding patient outcomes (n = 6, 8%). Most respondents agreed the practice should be based on empirical evidence, including a combination of improved patient outcomes (57, 76%), rate of contamination of supplies within the supply carts (55, 73%), and survivability of pathogens inoculated onto paper (56, 75%). Most respondents agreed they would be comfortable with a randomized controlled trial (RCT) (52, 69%) and would support action based upon the results (54, 72%). The RCT outcome most consistently ranked as 1 or 2 was next patient nosocomial infection with a pathogen from the previous patient (23, 31%); other outcomes ranked as 1 to 4 included next patient colonization with a pathogen from the previous patient (44, 59%) and pathogen detection on supplies within the supply cart (43, 57%). Intensivists were more likely to rank a preferred outcome as next patient(s) nosocomial infection with a pathogen from the previous patient (p = 0.005). Conclusions Results are limited by potential response bias and small sample size. Most respondents agreed the IPC practice was not based on empirical evidence, should be based on empirical evidence, and would agree to an RCT with patient-important outcomes. Future study should determine empirical support (or not) for this practice. This abstract is funded by: This abstract submission was supported by funding from a Sepsis Canada Trainee Grant awarded to Shellie Severson in October 2024.
Severson et al. (Fri,) studied this question.