Infection Control In NICU

Infection Control In Neonatal Intensive Care Unit

1. Infection C ontrol i n Neonatal Intensive Care U nit By: Honida juwili

2. Introduction Newborn babies who need intensive medical attention are often admitted into a special area of the hospital called the Neonatal Intensive Care Unit (NICU). The NICU combines advanced technology and trained health care professionals to provide specialized care for the tiniest patients. NICUs may also have intermediate or continuing care areas for babies who are not as sick but do need specialized nursing care Some newborn babies will require care in a NICU, and giving birth to a sick or premature baby can be quite unexpected for any parent.

3. Host risk factors for infection in newborns include Low birth weigh - Acuity of underlying illness - Immature immune system - Permeable skin -

4. Some studies have shown, type of infection in newborn 1- Bacterial infection **Gram positive infections Staphylococcus aureus - Strepto pyogenes - **Gram negative infections E.coli - Pseudomonas - Neisseria meningitides -

5. 2-Viral infections - Hepatitis HIV - Herpes - 3-Fungal infections: Candidiasis - 4-Parasitic infections -Toxoplasmosis

6. According to provincial infectious diseases advisory committee (PIDAC) The types of infection transmission are: 1-contact transmission * Direct contact : occurs through touching the patient ex, colonized or infected microorganism from staff. * Indirect contact : occurs when microorganism transferred from patient to patient via contaminated objects or the contaminated hands of health care provider.

7. 2-Droplet transmission Newborns known or suspected of having an infection that can be transmitted by large respiratory droplets such as cough or sneeze that travels for up to two meters Example of microorganisms transmitted by droplet transmission include: respiratory tract viruses (e.g. Adenovirus, influenza and Para influenza viruses, rhinovirus, RSV), rubella, mumps and Bordetella pertussis

8. 3-Airborne transmission Airborne transmission occurs when airborne particles remain suspended in the air, travel on air currents and are then inhaled by others who are nearby or who may be some distance away from newborns or if there have been insufficient air exchange. The only microorganisms transmitted by the airborne rout are Mycobacterium tuberculosis (TB), varicella virus (chickenpox virus) and measles virus.

9. Aims This paper is aimed to: - Control and prevention nosocomial infection in neonatal intensive care unit (NICU). -Provide and identify hospital and health care facilities policy information.

10. infection control precaution *staff precaution: 1-Hand hygiene: Removal of visible soil and microorganism. Five moments for hand hygiene: - before touching the patient. - before clean/aseptic procedure. - after body fluid exposure risk. - after touching the patient. - after touching the patient surroundings.

11. *Impediments to effective hand hygiene: - Accessories - long nail - nail polish - artificial nail

12. 2- Personal protective equipment "PPE" - gloves - gowns - facial protection - caps - boots Personal protective equipment (PPE) is worn to prevent transmission of microorganisms from patient to patient and from patient to staff or from staff to patient. To protect newborns health unit care staff should take necessary vaccinations that effect them (measles ,mumps ,rubella, pertussis ,varicella , hepatitis B and influenza vaccine).

13. * Environmental precautions: Observe cleaning in unit care environment is important to newborns safety ,staff and visitors. Daily cleaning and disinfection the environment surface should be in frequent period.

14. *Equipment precautions: The medical equipment should be clean and sterilized. The cleaning and disinfection of the equipment on consistent basis following with cleaning methods and instructions for equipment .

15. *visitor precautions: For safe visit to the newborns and spending time or checking on them should occur depending on some considerations: - Limiting number of visitors. - visitors or family members should not visit if they have signs and symptoms of being ill or unwell, such as: Fever cough or influenza runny nose vomiting or diarrhea rash conjunctivitis. - hand hygiene before and after visiting. - the visitor should be wearing personal protective equipment.

16. *Patient precautions: - neonatal skin care : Bathing - management of central venous catheters - management of peripheral arterial catheters - management of umbilical artery and vein catheters - prevention of ventilator associated pneumonia

17. Recommendations To provide a clean and safe neonatal intensive care unit Along with hospital infection control policy reviewed for newborn babies this paper recommended that : *for staff: Staff have infection illness should be excluded from work. Hand hygiene including : hand washing , hand rub. - Personal protective equipment including : gloves, gowns, boots, caps, - masks.

18. . *for Environment: - clean neonatal intensive care unit at least twice per day and additionally as required. - clean isolettes / warmers according to schedule and additionally as required. - terminally clean neonatal intensive care unit isolette / warmer and environment on discharge of the newborn. - terminally clean transport equipment after each newborn transport. Frequent audits of practice should be included as part of the organization's responsibility for maintaining a clean environment.

19. * fo r e quipment: Reusable medical equipment must be cleanable and be to able to be disinfected or sterilized. *for visitor: Family members and others should not visit if they are unwell .