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Standard Precautions for Infection Control in Newborns

Site: EHC | Egyptian Health Council
Course: دلائل الاجراءات التمريضية لقسم حديث الولاده
Book: Standard Precautions for Infection Control in Newborns
Printed by: Guest user
Date: Tuesday, 5 May 2026, 11:38 PM

Description

"last update: 22 January 2025"                                                                                تحميل الدليل  

Table of contents

- Prepared by

NICU guide

Under supervision

- Prof. Dr. Mohamed Latif, CEO of the Egyptian Health Council

 Dr. Kawthar Mahmoud, Head of the Egyptian Nursing Syndicate - Member of the Senate

 

Prepared by 

Title  

Name

NO.

Dean Of Faculty Nursing, Professor of Medical and Surgical Nursing, Tanta University

Dr Afaf Abdel Aziz Abdel Aziz Basal

1

Professor Of Critical Care Nursing

Prof.Dr/Zeinab Hussain Ali

2

Professor And Head of the Department of Medical Surgical Nursing. Faculty-. Benha University

Amal Said Taha Refaie

3

Supervisor Of the Education Sector at Port Said University

Amal Ahmed Khalil Morsy

4

Professor Of Medical Surgical Nursing- Faculty of Nursing- Cairo University

Dr. Hanan Ahmed Al Sebaee

5

Head of central administration on secondment at MOHP

Dr Neveen ab drab al0nabi Mohamed

6

Director Of Primary Health Care Nursing Department at MOHP.

Maysa Hosny Ahmed Tammam

7

Supervisor Of Technical Education- EHA 

Nancy Alaa Eldeen Abd-Elbaset Ali

8

Supervisor Of Nursing Services Development- EHA

Sherien Mohamed Saad

9

Assistant Professor of Maternity and Neonatal Health Nursing - Faculty of Nursing- Ain Shams University

Assist.Perof. Dr./Heba Mahmoud Mohammed

10

General manager of general administration of health institutes affairs

Dr Mai Galal Ibrahim Al-Assal

11

Participants  

Professor of Obstetrics and Gynecology Nursing

Dr. Nagat Salah Shalabi Salama

12

member of the Nursing administration at EHA, port said branch

Mrs. Shaima Abdel Basset Ibrahim Salim

13

member of the Nursing administration at EHA, port said branch

Mrs. Hoda Al-Sayd Muhammad

14

member of the Nursing administration at EHA, port said branch

Mrs. Walaa Ahmed Ali

15

member of the Nursing administration at EHA, port said branch

Mrs. Omnia Abdel Qader Muhammad

16

member of the Nursing administration at EHA- South Sinai

  branch

Mrs. Yasser Abdel Karim Omar Abdel Jawad

17

- Standard Precautions for Infection Control

Infection Control in the Neonatal Intensive Care Unit (NICU)

Modes of Infection Transmission in NICU:

  1. Hands of healthcare providers.
  2. Infection transmitted through droplets.
  3. Airborne infections (relatively rare).
  4. Infection from external sources, such as contaminated IV solutions and drugs:
    • Contamination of respiratory care equipment.
    • Presence of waterborne microbial reservoirs.

Signs of Infection in Neonates:

  • Poor general condition.
  • Pallor.
  • Swelling.
  • Irregular heartbeat.
  • Irregular breathing.
  • Shortness of breath.
  • Reduced movement and activity.
  • Irregular eye movements.
  • Poor feeding.
  • Vomiting.
  • Enlarged spleen.
  • Diarrhea or reduced bowel movements.
  • Presence of blood in stool.
  • Jaundice.

First: Hand Hygiene

Types of Handwashing:

1. Routine Handwashing (Water and Soap) - Duration: 40 seconds to 1 minute

    • Removes dirt, organic matter, and transient bacteria.
    • Required in the following situations:
      • Before and after any contact with the infant (diaper change, bathing, clinical examination, feeding, etc.).
      • After touching surfaces.
      • After removing gloves.
      • Before preparing formula feeds.

2. Alcohol Hand Rub - Duration: 30 seconds

    • Alternative to routine handwashing if hands are not visibly dirty or contaminated.
    • Should be used before wearing sterile gloves for procedures such as wound dressing and suturing, especially in immunocompromised infants.

3. Surgical Handwashing (7.5% Povidone-Iodine) - Duration: 3 to 5 minutes

    • Hands should be dried with a sterile towel and sterile gloves should be worn for procedures such as:
      • Surgeries.
      • Central Venous Catheter (CVP) insertion.
      • Umbilical catheterization.
      • Chest tube insertion.

Five Moments for Hand Hygiene:

  1. Before touching the patient.
  2. Before performing any routine or invasive procedure.
  3. After touching the patient.
  4. After contact with the patient’s environment.
  5. After exposure to body fluids.

Second: Isolation Precautions

Order of Wearing Personal Protective Equipment (PPE) in Isolation Rooms:

  1. Hand hygiene, then wear the gown.
  2. Head cover and mask (surgical or N95, depending on isolation type).
  3. Face shield.
  4. Gloves.

Order of Removing PPE:

  1. Remove gloves, then wash or sanitize hands.
  2. Remove the face shield, then wash or sanitize hands.
  3. Remove the gown, then wash or sanitize hands.
  4. Remove the head cover and mask, then wash or sanitize hands.

Order of Wearing PPE for Sterile Invasive Procedures (e.g., Umbilical Catheterization):

  1. Head cover.
  2. Mask.
  3. Surgical handwashing.
  4. Sterile gown.
  5. Sterile gloves.

Third: Personal Protective Equipment (PPE)

·  Gloves:

    • Must be worn during procedures and hands should be washed before and after use.
    • Avoid touching surfaces, medical records, or cabinets while wearing gloves.
    • Sterile gloves are required for procedures such as:
      • Surgeries.
      • CVP insertion.
      • Umbilical catheterization.
      • CSF sampling (spinal tap).
      • Chest tube insertion.
      • Urinary catheterization.
      • Wound dressing and suturing.
      • Mixing IV solutions.

· Clean Gown:

    • Worn during patient care, in isolation rooms, for wound dressing, suturing, and urinary catheterization.

- Needlestick Injuries

  • Wash the site with soap and water (do not squeeze the wound).
  • Report to infection control for virus screening (immediate and after 6 months).
  • Document the incident and send an OVR (Occurrence Variance Report) to the quality department.
  • Needlestick Prevention:
    • Never recap, detach, or bend needles.
    • If recapping is necessary, follow the one-handed scoop technique.
  • In case of blood or bodily fluid exposure to the eyes, rinse immediately at the nearest eye wash station.

- Handling Infectious Spills (Blood, Urine, etc.)

  1. Place a caution sign and bring the spill kit.
  2. The staff member wears PPE and double gloves.
  3. Clean the spill from the outside in using cotton or dressing and dispose of it in a red biohazard bag.
  4. Apply 1:9 diluted bleach for 10 minutes.
  5. Remove bleach residue with another piece of cotton.
  6. Clean floors with soap and water, then disinfect with 20 ml bleach per liter of water.
  • For small blood spills: Wipe with a cotton pad soaked in 20 ml bleach per liter of water.
  • Daily Surface Disinfection:
    • General areas: 20 ml bleach per liter of water.
    • Isolation rooms and waste storage areas: 1:9 diluted bleach.
  • All units follow a scheduled cleaning routine and additional cleaning when necessary.

Sixth: Medical Waste Management

·        Waste Segregation:

    • Black bags – General waste.
    • Red bags – Hazardous waste.
    • Safety boxes – Sharp waste (close when ¾ full or after one week, per facility policy).
    • Blue bags – Contaminated laundry.

·        Instrument Decontamination:

    • Soak instruments in enzyme solution before sending them for sterilization.