Complex infection control strategies at the neonatal intensive care unit with a special focus on hand hygiene

2017 ◽  
Author(s):  
Borbála Szél
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Infection Control ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Control Strategies ◽  
Special Focus

scholarly journals Nosocomial infections in neonatal intensive care units: Cost-effective control strategies in resource-limited countries

2013 ◽  
Vol 40 (2) ◽  
pp. 125-132
Author(s):  
SN Uwaezuoke ◽  
HA Obu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Neonatal Intensive Care Unit ◽  
Nosocomial Infections ◽  
Neonatal Intensive Care ◽  
Control Strategies ◽  
Cost Effective ◽  
Effective Control ◽  
Resource Limited

Background: Nosocomial infections or hospital-acquired infectionsconstitute a global health problem. They lead to significant morbidity and mortality in both developed and resource-limited countries. The neonatal intensive care unit (NICU) is a suitable environment for disseminating these infections; underscoring the need for preventive intervention measures.Objectives: This review aims to highlight the global burden of nosocomialinfections in neonatal intensive care units (NICUs), to discuss their epidemiology and clinical spectrum, as well as the costeffective control strategies in resource-limited settings.Sources: Sources of information were from Google searches andPubMed- linked articles using the key words- nosocomial infections,neonatal intensive care unit, control. Related articles from hard copiesof medical literature and journals were also gathered.Results: Although paucity of data exists on the incidence of nosocomialinfections in NICUs in developing countries, reports from developedcountries indicate a range of 6% to 25%. Much higher figures were noted in some developing countries. Several risk factors for nosocomial infections were identified but varied in different NICUs surveyed. Effective control strategies have been recommended but hand washing or hand hygiene appears universally applicable in both developed and resource-limitedcountries. Economic analyses of these strategies in developed countrieshave established their costeffectiveness while the adaptability of hand hygiene program to resource-limited settings has been demonstrated in a World Health Organization pilot study in sub- Saharan Africa.Conclusion: Hand washing or hand hygiene by health-care personnelremains the most important evidence-based and cost-effective controlstrategy for the spread of nosocomial infections in NICUs in resource-limited countries.Key words: nosocomial infections; neonatal intensive care unit;control.

Infection control strategies in a neonatal intensive care unit in Argentina

1998 ◽  
Vol 40 (2) ◽  
pp. 149-154 ◽  
Author(s):  
I. Kurlat ◽  
G. Corral ◽  
F. Oliveira ◽  
G. Farinella ◽  
E. Alvarez
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Control Strategies

Addressing Hand Hygiene Compliance in a Low-Resource Neonatal Intensive Care Unit: a Quality Improvement Project

2018 ◽  
Vol 8 (5) ◽  
pp. 408-413 ◽  
Author(s):  
Arunava Biswas ◽  
Sangeeta Das Bhattacharya ◽  
Arun Kumarendu Singh ◽  
Mallika Saha
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Neonatal Intensive Care Unit ◽  
Conceptual Framework ◽  
Neonatal Intensive Care ◽  
Hand Hygiene Compliance ◽  
Hand Washing ◽  
Root Cause ◽  
Hygiene Compliance

Abstract Objective Our goal for this study was to quantify healthcare provider compliance with hand hygiene protocols and develop a conceptual framework for increasing hand hygiene compliance in a low-resource neonatal intensive care unit. Materials and Methods We developed a 3-phase intervention that involved departmental discussion, audit, and follow-up action. A 4-month unobtrusive audit during night and day shifts was performed. The audit results were presented, and a conceptual framework of barriers to and solutions for increasing hand hygiene compliance was developed collectively. Results A total of 1308 hand hygiene opportunities were observed. Among 1227 planned patient contacts, hand-washing events (707 [58.6%]), hand rub events (442 [36%]), and missed hand hygiene (78 [6.4%]) events were observed. The missed hand hygiene rate was 20% during resuscitation. Missed hand hygiene opportunities occurred 3.2 times (95% confidence interval, 1.9–5.3 times) more often during resuscitation procedures than during planned contact and 6.14 times (95% confidence interval, 2.36–16.01 times) more often when providers moved between patients. Structural and process determinants of hand hygiene noncompliance were identified through a root-cause analysis in which all members of the neonatal intensive care unit team participated. The mean hand-washing duration was 40 seconds. In 83% of cases, drying hands after washing was neglected. Hand recontamination after hand-washing was seen in 77% of the cases. Washing up to elbow level was observed in 27% of hand-wash events. After departmental review of the study results, hand rubs were placed at each bassinet to address these missed opportunities. Conclusions Hand hygiene was suboptimal during resuscitation procedures and between patient contacts. We developed a conceptual framework for improving hand hygiene through a root-cause analysis.

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