New study finds a decrease in S aureus infections in NICU following new guidelines for parent cleansing prior to skin-to-skin contact.
Neonatal intensive care units (NICU) have been encouraging parents to engage in skin-to-skin care with their premature infants to aid in development. However, in a Michigan children’s hospital, staff noticed an increase in Staphylococcus aureus (S aureus) infections in newborns, hypothesized to be connected with skin-to-skin contact.
The research was presented at the 45th Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC).
To combat the infections, the hospital implemented a 3-part intervention in the unit: increase awareness of hand hygiene, conduct mandatory online staff education about S aureus, and implement parent skin cleansing prior to contact with infants. Following online education, the nurses educated parents and family about the new cleaning requirements and the importance of the new practices.
According to the research, in the year following the implementation of the 3-part intervention, 20 infants in the NICU developed S aureus infections, which was a decrease from the 59 reported cases in the year prior. Additionally, in a follow-up survey, 98% of the hospital staff were familiar with the requirements for skin cleansing.
"We know that skin-to-skin care and meaningful touch are good for the baby, but the increase in infections showed how this type of caregiving can carry a risk. The results demonstrate that interventions even as simple as cleaning the skin prior to care can drastically improve infection rates." Gwen Westerling, BSN, RN, CIC, the study's lead author and infection preventionist at Spectrum Health Helen DeVos Children's Hospital, said in a statement.
In a comment to Contagion®, Westerling described the procedure and reaction to the cleansing. “The requirements of parental skin cleansing are using pre-packaged bath wipes to wash any skin that will be exposed during skin to skin care. Hand hygiene is done as well,” she said. “We require the cleansing for all our small baby unit patients and patients with central lines. Parents are educated about the required cleansing by the nursing staff. Parent compliance was one of our survey questions and very few RNs reported having a parent refuse to cleanse.”
Westerling also indicated that the Michigan hospital is currently experiencing a minimal number of S aureus infections and, as such, the NICU will continue to utilize the procedures while seeking a goal of zero infections.
"Infection preventionists are uniquely attuned to the impact that process changes may have on the risk of infection," said 2018 APIC President Janet Haas, PhD, RN, CIC, FSHE, FAPIC. "Increased education around hand hygiene and cleaning procedures may seem straightforward, but we see again and again that they are key components in the reduction of healthcare-associated infections."