1 Goal and learning outcomes Every newborn receives care that integrates evidencebased infection prevention and control Perform correct hand hygiene and respiratory etiquette Use personal protective equipment PPE correctly ID: 1040853
Download Presentation The PPT/PDF document "Infection prevention for newborns" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
1. Infection prevention for newborns
2. 1. Goal and learning outcomesEvery newborn receives care that integrates evidence-based infection prevention and control.Perform correct hand hygiene and respiratory etiquette.Use personal protective equipment (PPE) correctly.Ensure equipment and the environment are clean and disinfected.Dispose of waste safely.
3. 2. The situationWhat Women Want survey: Demands for quality healthcare for women and girls (2019) 1.2 Million women surveyed https://www.whatwomenwant.org/https://www.thelancet.com/pdfs/journals/langlo/PIIS2214-109X(17)30101-8.pdf
4. 3. Do you practise correct hand hygiene?Hand hygiene using fluorescent gel
5. 3.1 Ensure hand hygieneNurses and midwives, clean care is in your hands!
6. 3.2 Moments of hand hygiene Before entering labor, childbirth, postnatal and neonatal wardsBefore touching mother or newbornBefore any procedureAfter risk of exposure to body fluidAfter touching a patientAfter touching patient’s surroundingAfter removing glovesWHO Guidelines on hand hygiene in health care. WHO, 2009.
7. 3.3 Appropriate hand hygieneThe safe hands challenge. WHO, 2020.0:52–2:00
8. 4. What are the standard precautions? Hand hygiene Selection and appropriate use of PPE Correct glove use Safe handling and disposal of sharpsDecontamination, cleaning and sterilization of medical devices between each useSafe health care waste managementSafe handling of used/contaminated linenOverview: preventing infection at birth 0:00–07:00Protect mother, baby and yourself. Apply the standard precautions.
9. 4.1 Safe glove use Wearing the same pair of gloves or washing gloved hands between patients is a dangerous practice. DO NOT REUSE GLOVES. Glove use does not replace hand hygiene by handrubbing or handwashing.Gloves do NOT protect against needle-stick or other puncture wounds.Incorrect glove use can result in infections.Infections can kill.STERILE GLOVES INDICATED:Any surgical procedure, vaginal delivery, cord cutting
10. 4.2 Safe use of gloves When do you put ON gloves?When do you take OFF gloves?Before a sterile procedure.When anticipating contact with blood or another body fluid, regardless of the existence of sterile conditions, including contact with non-intact skin or mucous membrane.Contact with a patient (and his/her immediate surroundings) As soon as gloves are damaged (or loss of integrity is suspected).When contact with blood, another body fluid, non-intact skin or mucous membrane occurred and has now ended.When contact with a single patient and his/her surroundings or a patient’s contaminated body site has ended.When there is an indication for hand hygiene.
11. 4.3 Which gloves would you select? Vaginal delivery?Handling/cleaning instruments? Cleaning up spills of body fluids?Examining the newborn?Changing blood-stained sheets?Vaginal examination?Clamping and cutting cord?Emptying emesis basins?Handling waste?Vaccinating the newborn?Environmental cleaning?Support mother to express breast milk?Sterile glovesExamination glovesExamination glovesExamination glovesExamination glovesSterile glovesSterile glovesExamination glovesExamination glovesExamination glovesUtility glovesHand hygiene
12. 4.4 Use personal protective equipment (PPE) correctly ASSESS THE RISK of exposure BEFORE any health care activity. Follow infection prevention guidelines.Select PPE based on your assessment and the task. Correct glovesClean, non-sterile, fluid-resistant gownMask and eye protection or face shieldPerform hand hygiene.PAHO/WHO. Proper use of PPE 0:45-4:00WHO. How to wear a medical mask 0:25-2:10
13. 4.5 Practise safe handling of sharpsUse extreme caution when handling needles, scalpels and other sharp instruments or devices or cleaning used instruments.Dispose of correctly to prevent needle-stick and other injuries.Keep a puncture-resistant, easily identifiable container next to every point of care.Drop all used (disposable) needles, syringes and blades directly into this container, without recapping and without passing to another person.Do not reuse needles or syringes.Do not recap, bend or break needles after giving an injection.Process sharps boxes following local regulations.
14. 4.6 Practise safe handling of placenta, body fluids and clinical wasteEnsure safe waste management:Treat waste contaminated with blood, body fluids, secretions and excretions as clinical waste, in accordance with local regulations.Treat human tissues and laboratory waste as clinical waste. Segregate waste into correctly labelled bins less than 5 metres from point of generation.Treat and dispose of waste safely by autoclaving, incineration (850 °C to 1100 °C) and/or burial in a lined, protected pit.Waste segregation and disposal 0:10-3:50Reference: Water, sanitation, hygiene, and waste management. WHO, 2020.
15. 4.7 Decontaminate, clean and sterilize medical devices between each patient useAlways follow guidelines. All instruments that penetrate the skin must be clean. Disinfect all equipment between uses. Dispose of single-use instruments after one use.Thoroughly clean, decontaminate and sterilize equipment that comes into contact with non-intact skin.Use 0.5% bleach for cleaning bowls, buckets, blood or body fluid spills.
16. IPC actionsEquipment4.8 What IPC actions and equipment are needed to prepare for a birth?Check all essential and emergency equipment for cleanliness. Check integrity and sterility of all materials, for example, delivery pack, suture packs.Check mattresses and other furniture for integrity.Check that all surfaces are clean and disinfected. Ensure fresh and clean linen and curtains around bed.Check refrigerator temperatures.Discuss with woman and companion IPC practices during childbirth, particularly hand hygiene.Hand hygiene supplies: soap, water and alcohol-based handrub close to point of carePPE according to exposure risk and, for aseptic technique, gloves, long plastic apron, eye protectionSharps containers Waste segregation facilitiesReceptacle for soiled linens
17. 5. Supervise for clean, safe environment for newborn careAt the beginning of each day:All flat surfaces should be wiped with a clean, lint-free, moist cloth to remove dust and dirt. Start cleaning cleanest areas first and work towards the dirty/contaminated areas, for example, floors.Damp-clean floors daily – and immediately if any spillage.During the day:Between patients: Using detergent, wipe clean all surfaces in contact with mother, newborn or their body fluids. Then disinfect according to hospital policy and allowed to dry.Clean toilets and sinks at the beginning of each shift or more often if needed.The cleaning roster should be signed with date and time of each cleaning task performed.WHO cleaning and disinfection environmental surfaces. 2020.
18. 5.1 Supervise at the end of each dayTotal cleaning procedure, whether or not room or equipment was used during the last 24 hours:Labour roomPostnatal wardsSurgical suiteScrub sinksScrub or utility areasHallwaysEquipmentHow to clean floors, walls and other surfaces v
19. 5.2 Supervise and ensure linen is handled safelyLaundry and bed linen need to be changed between patient uses.Collect clothing or sheets stained with blood or body fluids and keep them separately from other laundry. Wear gloves. Use a plastic bag. Do NOT touch them directly.Manage according to hospital policy.In laundry use appropriate PPE. Rinse off blood or other body fluids before washing with soap.
20. 5.3 What physical environment is essential for quality newborn care?Water, energy supply, sanitation, handwashing and waste-disposal facilitiesImproved sanitation facilities (toilets) Easily accessible hand hygiene stations inside wardAt least one functioning hand hygiene station with soap and water before entrance to the newborn wardLeak-proof, covered waste bins and impenetrable sharps containersSufficient trained and competent staffOrganization of care and services
21. 6. After delivery Meena is suspected of having COVID-19. What measures will you ensure are in place? Good respiratory hygiene, including wearing a medical maskPrevention of aerosol transmissionCoughing or sneezing into one’s bent elbow or a tissue and dispose of the tissue immediately.Routine cleaning and disinfection of surfaces in mother and baby’s zone.Routine environmental cleaning and disinfectionSupport for breastfeeding. Ensuring hand washing before and after.
22. 6.1 What respiratory hygiene and cough etiquette should be in place for Meena?Meena should:Health care facilities should: Health care workers should: When coughing or sneezing, cover her nose and mouth with tissue or mask.Correct use of maskDispose of used tissues and masks.Perform hand hygiene after contact with respiratory secretions. Place acute febrile and respiratory symptomatic patients at least 1 meter (3 feet) away from others in common waiting areas. Post visual alerts at the entrance to health care facilities instructing persons with respiratory symptoms to practise respiratory hygiene/cough etiquette. Make hand hygiene resources, tissues and masks available in common areas and areas used for evaluation of patients with respiratory illnesses. Perform hand hygiene after contact with respiratory secretions.
23. 7. SummaryIn this module you have learned:The importance of infection prevention to save lives and prevent disabilities.How to perform correct hand hygiene and respiratory etiquette and how to use appropriate PPE.How equipment and the environment should be cleaned and disinfected.Safe clinical waste disposalYou will apply what you have learned about infection prevention measures throughout the course and whenever caring for women and newborns.Ensure that infection prevention and control guidelines are always applied when caring for mothers and babies.Quickly look at pages 73–77 in the EENC clinical practice pocket guide
24. 8. How should we clean and disinfect the environment in the context of COVID-19?Find the answer on pages 1–4.
25. 8.1 WHO guidance for cleaning and disinfection during COVID-19 outbreakSurfaces should always be cleaned by:First removing organic matter with soap and water or a detergentThen disinfection to kill microorganismsIn health care settings, use:Ethanol 70–90%Chlorine-based products (for example, hypochlorite) at 0.1% (1000 ppm) for general environmental disinfection or 0.5% (5000 ppm) for large spills of blood or body fluids.Hydrogen peroxide ≥0.5%.In non-health care settings, use:Sodium hypochlorite (bleach) at the recommended concentration of 0.1% (1000 ppm). Alternatively, alcohol with 70––90% concentration may be used for surface disinfection.Review evidence:Interim guidance: cleaning and disinfection of environmental surfaces in the context of COVID-19. WHO, 2020.
26. 9. Clinical practice
27. 9.1 Topics that may need discussion after clinical practice Overcrowding and understaffingWard or delivery room layout (sinks, bed spacing)Standards for WASH in health facilities applied?Hand hygiene points for mothers; functioning hand hygiene stations at points of care; accessible functioning toilets Suboptimal cleaning, disinfection and sterilization practicesIf alternative warming methods are indicated, are bassinets, warmers and incubators are cleaned and disinfected between newborn patients?Toys and other objects in incubators that cannot be adequately cleaned.Segregation of outborn neonates admitted with infectionsCohorting mothers and isolating mothers with same infections Routine surveillance of infections Vaccination of health care workers
28. 10. Improving the quality of care formothers and newborns in health facilitiesIdentify a problem Analyze the problem Develop and test changes 4. Sustain improvement 4 simple steps:(POCQI) QUALITY IMPROVEMENT TEMPLATEModules/Sessions:Step 1: Identify a set of specific problems, prioritize which problem to tackle first, form a team, and write an “aim” statement.Problem Identified………………………………………………………………………………………………………………………………………..Team Aim Statement……………………………………………………………………………………………………………………………………………………………..Who Needs to be Involved…………………………………………………………………………………………………………………………………………..Step 2: Analyse the problem, measure and document quality of care.Analyses/Measures…………………………………………………………………………………………………………………………………………..Step 3: Develop and test changes that can improve the quality of care.Possible Changes…………………………………………………………………………………………………………………………………………..Actions – When Who…………………………………………………………………………………………………………………………………………..Step 4: Sustain Improvement.
29. 10.1 ReferencesWHO course: PPEHandwashing NICU 2013Nurses and midwives, clean care is in your hands!