Symposium 22.8.

2013

General Guidelines
Prevention of overcrowding Allowance of entry only after hand washing and gowning Separate footwear Medical professionals separate uniform code No ornaments/nail polish/wristwatches to be used inside No hospital personnel should enter without valid reason Buffer zone maintenance between patients and relatives

Guidelines for Entry

Operation theatre Labor room Neonatal Intensive Care Unit High Dependency Unit

Operation Theatre
All cannot enter the operating area without prior permission. Only authorized personnel with identification should be allowed. All who enter should be strictly supervised for breach of sterile precautions. Any breach in sterile technique even committed by mistake should not be tolerated. Proper orientation is required for any one who enters the OT about the protocols and infection standards.

Guidelines for Entry

Operation theatre Labor room

Neonatal Intensive Care Unit

High Dependency Unit

Birthing Area
All doctors and nurses should enter and exit the birthing suite after washing hands. Make sure personal items are left away from the patient premises. Do not allow relatives with infections or without hand washing (on entry and exit). Maintain separate exits for maintenance staff and medical personnel. Maintain buffer zone where the consent can be taken, the explanations are given by the midwife or obstetrician, showing the baby to the significant others

Guidelines for Entry

Operation theatre Labor room Neonatal Intensive Care Unit High Dependency Unit

Neonatal Care Unit

No overcrowding STRICTLY. No medical or support personnel or parent with active infections should be allowed to enter. Instruct all personnel to wash hands with a bactericidal soap solution before entry and exit from unit. Special gowns for parents and separate areas for feeding mothers and KMC . Infected babies should be handled in an adequately isolated unit with suitable barrier facilities

 Operation theatre

Labor room
Neonatal Intensive Care

Unit
High Dependency Unit

High Dependency Unit

Strict control of visitors Separate entry and exit for relatives and medical personnel. Strict hand washing before and after visiting STRICT supervised hours for visit by significant others. The patient visitors should not be allowed to touch the tubing/bed linens/patient items.

Special Precautions to Infection Prevention in Neonates

Medical Personnel

 Handling of the infant to be REDUCED. Reduce unnecessary admissions into NURSERY. Exclusive breast feeding to be provided. Involve the mother in care of baby. Clean daily with warm sterile water with special attention to groin, axilla and neck. Bathe infant after body weight reaches 2.5 kg. Regular position changing prevent skin abrasions. Keep umbilicus clean and dry.

Procedures

 FOLLOW the skin preparation policy Prepare smallest area of skin as follows:
Swab with alcohol first and allow it to dry Swab iodine on site and allow it to dry Swab again with alcohol to wipe off iodine and allow it to dry.

Change peripheral IV fluid set and tubing every 24 - 48 hours. Never share fluid in same bottle between babies. No repeated puncturing of bottles. If opened clean with spirit swab and then keep it covered with Betadine soaked sterile cotton.

 All fluids except lipids and blood SHOULD be given through the filter. STRICT ASEPTIC TECHNIQUE to be followed during preparation and administration of fluid therapy. Use non invasive methods of monitoring Universal precautions during all procedures Use of sterile gloves for ALL invasive procedures including endotracheal suctioning. All invasive procedures surgical asepsis

Routine surveillance Environmental cultures once every 4 months

Representative
surfaces Laminar flow devices AC vents Refrigerators Sinks

Equipments
Fomites

Taps