Effect of camera monitoring and feedback along with training on hospital infection rate in a neonatal intensive care unit

Abstract

BackgroundIn terms of pediatric healthcare-associated infections (HAI), neonatal intensive care units (NICU) constitute the greatest risk. Contacting a health care personnel, either directly or indirectly, elevates NICU occurrence rate and risks other infants in the same unit. In this study, it is aimed to retrospectively analyze the effect of the training along with camera monitoring and feedback (CMAF) to control the infection following a small outbreak.MethodsESBL producing Klebsiella pneumoniae was detected on three infants in May 2014 at the isolation room of Sakarya University Hospital NICU. Precautions were taken to prevent further spread of the infection. The infected infants were isolated and the decolonization process was initiated. For this aspect, health care workers (HCWs) in NICU were trained for infection control measures. An infection control committee has monitored the HCWs. Before monitoring, an approval was obtained from the hospital management and HCWs were informed about the CMAF, who were then periodically updated. On a weekly basis, NICU workers were provided with the feedbacks. Epidemic period and post-epidemic control period (June–July–August 2014) were evaluated and p value < 0.05 was considered statistically significant.ResultsHealthcare-associated infection (HAI) density was 9.59% before the onset of the CMAF, whereas it was detected as 2.24% during the CMAF period (p < 0.05). Following the precautions, HAI and HAI density rates have reduced to 76.6% and 74.85%, respectively. Moreover, hand hygiene compliance of health care workers was found 49.0% before the outbreak, whereas this rate has elevated to 62.7% after CMAF.ConclusionsHealthcare workers should be monitored in order to increase their compliance for infection control measures. Here, we emphasized that that CMAF of health workers may contribute reducing the HAI rate in the NICU.

Neonatal Sepsis in Nigeria 1: Introductory Overview

“…Furthermore, in both Nigeria and developing countries, klebsiella sp, E. Coli, and Staphylococcus aureus as well as GBS also constitute the most common nosocomial neonatal sepsis [11][12][13]. Some maternal factors associated with EOS include; maternal GBS colonization (if untreated before labour), rupture of membranes, maternal urinary tract infection, poor prenatal care, poor maternal nutrition amongst others [9,14,15]; while LOS causes include hospital procedures such as venous catheterization and healthcare professionals' noncompliance to aspeti principles [14,16,17].…”

“…Some maternal factors associated with EOS include; maternal GBS colonization (if untreated before labour), rupture of membranes, maternal urinary tract infection, poor prenatal care, poor maternal nutrition amongst others [9,14,15]; while LOS causes include hospital procedures such as venous catheterization and healthcare professionals' noncompliance to aspeti principles [14,16,17]. Hence, continuous education and monitoring of healthcare staff on hospital acquired infection and necessary compliance is part of infectious disease control in the neonatal intensive care units [13].…”

“…depending on infection stage, eye and skin may look yellow due to jaundice (eyes may have sunken appearance), a swelling in the stomach region, decrease in urination ( not passing urine in more than 12 hours), change in skin tone ( pale and patchy skin),reduction of blood platelet count, a decrease in blood pressure, bulging of the fontanel, a problem in taking breath, lethargic or floppy movements [4,11,13,18]. Sepsis is a medical emergency that is characterized with a disease condition with multiple causative organisms, and people with sepsis can present various signs and symptoms at different times.…”

“…Sepsis. A study from Malawi and Nepal indicates that maternal antisepsis intervention such as vaginal chlorhexidine during labour may have a significant impact on the rate of neonatal mortality and sepsis in developing countries [13].…”

“…Vancomycin should not be routinely used in the empirical antibiotic regimen in late neonatal sepsis, and the main protective mechanisms against neonatal sepsis are hand washing and the use of breast milk [18]. Management of a child with neonatal sepsis has several challenges hence it requires adequate and proper supportive care [11,13,18,21,23]. The child is nursed in a temperature-regulated environment to avoid fluctuations in body temperature.…”