Standard Precautions for Infection Control in Newborns

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.

·  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.