Newborn babies, especially premature infants, are particularly susceptible to infection. To minimize the risk of nosocomial infection, the following guidelines should be strictly adhered to in the NICU:

Visitors to the nursery, family members, physicians, nurses, and other personnel must wash hands before entering the nursery. To come into physical contact with a patient, all jewelry and watches should be removed and long sleeves should be rolled up above the elbows.   Physician’s white coats should not be worn inside the nursery.

Parents who’ve washed in the scrub room and then touched the doors to enter the nursery should wash their hands again before touching their infant.   Patient care-providers should wash their hands before and after patient contact.   All hospital personnel who visit other areas of the children’s hospital and then come into contact with patients in the NICU (for ex. respiratory therapists, X-ray technicians, radiologists, surgeons, and other consultants) must be diligent about hand-washing and infection control measures.

Personnel should be free of skin lesions, fever, vomiting and diarrhea, and reportable communicable diseases (TB, rubella, etc.) Personnel with any of the above conditions must be cleared to return to work by Occupational Health or the nurse manager on duty. Anyone with herpes simplex lesions of the mouth should wear a mask until the lesions are dry and crusted over for 24 hours.

Anyone with an upper respiratory infection should avoid entering the nursery if possible. If not possible, (s)he should wear a mask until symptoms (coughing/sneezing) abate. Gloving before patient contact is also advisable.

Any staff members who become ill after potential exposure to RSV should be evaluated by Occupational Health, where furlough decisions will be made on clinical grounds.   RSV antigen testing will also be performed for epidemiologic investigation.   Staff members with symptoms consistent with RSV will be sent home for 8 days (the duration of RSV viral shedding in adults).

Disposable diapers are used on all infants. Any object falling to the floor must be discarded, washed, disinfected or sterilized. Equipment is cleaned, disinfected, or sterilized between each infant’s use. All unused linen left in an infant’s bed upon discharge must be re-washed or discarded.

If indicated, isolation procedures will be followed as per CDC Guidelines.

Discussed at the Nursery Policy & Procedure meeting 3/15/00. This information can also be found in the NICU Nursing Guidelines 40:08.49.

Reference:

American Academy of Pediatrics. Infection Control. Guidelines for Perinatal Care, 4^th ed. 1997.