Infection prevention and control policy in nicu and infection control policy in nicu,

1. Dr. Md Noor Alam Khan
Dept. of Paediatrics
Dept. of Paediatrics
&
Dept. of Microbiology

2. Neonatal Sepsis
 Clinical Syndrome characterised by signs and
symptoms of infection with or without
accompanying bacteraemia

3. Neonatal
Sepsis
Mother’s Birth
canal
Across Placenta
Environment
With health
care facility

4. Care-related risk factors that
increase the risk of infection
•Intensive care stay
•Presence of invasive medical devices
•Parenteral nutrition
•Antimicrobial therapy which may lead to multiple
drug resistance organism (MDRO) infections
•Overcrowding and Understaffing

5. •Ward layout (sinks, bed spacing)
•Use of fetal scalp electrodes/ probes and canula
•Contact with colonized/ infected family, visitors, or
healthcare workers
•Proximity of colonized neonates.
•Increased length of stay

6. Prevent Entry of Microbes Into the
NICU
Infection Control Step I

7. A- Clean Immediate Environment
Prevent by 5C’s-
 Clean hand
 Clean delivery surface
 Clean cloth
 Clean cord cutting
 Clean cord Clamp

8. B-Standardize the NICU care
1-Location of NICU-
 Distinct area with controlled access
 Minimum 120 Sq ft clear floor space/baby
 Minimum 4 ft gap between 2 infant beds

9. 2-Airborne infection prevention –
 An airborne infection isolation room
 Hand fee hand washing station
 Area for gowning
 Negative pressure ventilation
 Relative humidity 30-60%
 ACH 6 for NICU, 12 for isolation room

10. 3-Hand washing station–
 Infant bed within 20 feet of HWS
 Free from splash
 Pictorial hand washing instructions
 Space for soap and towel dispensers

11. C-Hand hygiene

13. D-Use of Alcohol Based Hand
Rubs

14. E- Visitors’ policy/ Mobile
restriction

15. F-Gowning

16. G-Jewellery & Accessories
Policy

17. Prevent Proliferation of Microbe in the
NICU
Infection Control Step II

18.  Dry and clean NICU
 Good house keeping routines
 Daily routine cleaning
 Weekly routine cleaning
 Proper waste disposal

19. Preventing infection Spread from
Proliferation Sites to baby and From
one baby to another
Infection Control Step III

20. A- Nurse to Patient Ratio
1:1- Baby on
Ventilator, Critically
ill, MDR resistant
sepsis
1:2-3, Non
ventilated ,
relatively stable
baby

21. B-Use Disposables

22. C-Laminar Flow System For Drugs,
Fluids and TPN preparation

23. Prevent Entry Of Microbe Into The Baby
Infection Control Step IV

24.  Cord care
 Skin Care
 Aseptic precaution during procedures

25. Breast milk/Breastfeeding and Correct
Preparation of Formula Milk(when
Indicated)
Infection Control Step V

26.  Support and promote breastfeeding
 Encourage use of colostrum, trophic feeds and
non nutritive sucking
 If formula milk is needed, ensure adequate
and sterile preparation

27. Kangaroo Mother Care/ Early
Discharge
Infection Control Step VI

28.  KMC for LBW and premature baby
 Early step-down, rooming in
 Early discharge

29. Decreasing Susceptibility of Baby to
Infection
Infection Control Step VII

30. A-Early Breastfeeding/Use of
Colustrum/Minimal Enteral Nutrition

31.  B-Immunomodulators: like Probiotics
 C-Antifungal prophylaxis: Recommended for
extremely low birth weight baby

32. Infection Control Protocols
Infection Control Step VIII

33. A-Role of Hospital Management
 To provide adequate resources and staff, ward
attendants, housekeeping and other
supportive staff
 Arrangement of necessary equipments
 To establish a multidisciplinary Infection

34. B-Infection Control Committee
 Yearly programme of activity for surveillance
and prevention
 Epidemiological surveillance data and identify
area of interventions
 Appropriate staff training in infection control
and safety
 Provide inputs into investigation of epidemics

35. C-Antibiotic Usage and Microbial
Resistance
 Antibiotics policy depending on local
conditions
 Avoid prophylactic antibiotics
 Mandatory blood culture before starting of
antibiotics

36.  Narrow spectrum antibiotics should be used
 Shorten duration whenever possible
 Restrict Cephalosporin, Carbapenems &
Quinolones to Aminoglycoside and Penecillin
resistant microbes

37. Conclusion