Managing a tertiary‐level NICU in the time of COVID‐19: Lessons learned from a high‐risk zone

Cavicchiolo, Maria Elena; Lolli, Elisabetta; Trevisanuto, Daniele; Baraldi, Eugenio

doi:10.1002/ppul.24788

Cited by 21 publications

(36 citation statements)

References 3 publications

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“…However, the procedures outlined here allowed us to ensure continuity of care in the NICU, with limited risks of infection for newborns and HCWs. Although no newborns screened positive among NICU patients in the higher-risk Veneto region, 6 by testing all newborns before admission, we could have separated a positive neonate from other fragile infants, avoiding life-threatening risks for them and the incalculable costs of spreading the virus to the unit. The fight against the COVID-19 pandemic should not affect the quality of the assistance to high-risk infants.…”

Section: Discussionmentioning

confidence: 99%

Reshaping neonatal intensive care units (NICUs) to avoid the spread of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) to high-risk infants

Rose

Auriti

Landolfo

et al. 2020

Infect. Control Hosp. Epidemiol.

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Implementing a negative-pressure isolation ward for a surge in airborne infectious patients. Am J Infect Control 2017;45:652-659. 3. Glauser W. Proposed protocol to keep COVID-19 out of hospitals. CMAJ 2020;192:E264-E265. 4. Environmental control measures for airborne infection isolation surge capacity planning in health care facilities for smallpox, SARS or other infections. Potentially transmitted via airborne droplet nuclei.

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Section: Discussionmentioning

confidence: 99%

Reshaping neonatal intensive care units (NICUs) to avoid the spread of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) to high-risk infants

Rose

Auriti

Landolfo

et al. 2020

Infect. Control Hosp. Epidemiol.

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“…In cases where the other parent is also infected, they cannot visit the infant until the test results return negative. Furthermore, in an effort to reduce the risk of SARS-CoV-2 transmission, many NICUs have reduced parental (especially paternal) and family visitation privileges (Cavicchiolo et al, 2020a ; Murray and Swanson, 2020 ) regardless of the other parent's chance of being infected. Despite parents' understanding of the need for visitation restrictions, they are seriously concerned about their ability to visit, care for, and bond with their hospitalized infants (Muniraman et al, 2020 ).…”

Section: The Psychological Impact Of Covid-19mentioning

confidence: 99%

The Collateral Impact of COVID-19 Emergency on Neonatal Intensive Care Units and Family-Centered Care: Challenges and Opportunities

et al. 2021

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The ongoing Coronavirus disease 2019 (COVID-19) pandemic is disrupting most specialized healthcare services worldwide, including those for high-risk newborns and their families. Due to the risk of contagion, critically ill infants, relatives and professionals attending neonatal intensive care units (NICUs) are undergoing a profound remodeling of the organization and quality of care. In particular, mitigation strategies adopted to combat the COVID-19 pandemic may hinder the implementation of family-centered care within the NICU. This may put newborns at risk for several adverse effects, e.g., less weight gain, more nosocomial infections, increased length of NICU stay as well as long-term worse cognitive, emotional, and social development. This article aims to contribute to deepening the knowledge on the psychological impact of COVID-19 on parents and NICU staff members based on empirical data from the literature. We also provided evidence-based indications on how to safely empower families and support NICU staff facing such a threatening emergency, while preserving the crucial role of family-centered developmental care practices.

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“…We previously reported on the measures taken at the NICU to prevent or contain SARS-CoV-2 infections in sick neonates and preterm babies [16]. Briefly, the intervention focused on three aspects: (a) triage for parents on arrival at the neonatal ward, and training on measures for preventing infections; (b) universal testing with weekly nasopharyngeal swabs and quantitative polymerase chain reaction tests to detect SARS-CoV-2 infection in all neonates, parents, and healthcare staff, and testing for SARS-CoV-2 IgG and IgM antibodies in neonates; (c) continuous use of personal protective equipment (PPE) during neonatal care and at all times in the NICU.…”

Section: Interventionmentioning

confidence: 99%

Universal screening of high-risk neonates, parents, and staff at a neonatal intensive care unit during the SARS-CoV-2 pandemic

et al. 2020

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Since February 21, 2020, SARS-CoV-2 has spread exponentially worldwide. Neonatal patients needing intensive care are considered a vulnerable population. To report the results of a policy based on multi-timepoint surveillance for SARS-CoV-2 of all neonates admitted to the neonatal intensive care unit (NICU), their parents, and all healthcare providers in a part of Italy with a high prevalence of the infection. Observational study conducted from 21 February to 21 April 2020. Intervention consisted of (a) parental triage on arrival at the neonatal ward; (b) universal testing with nasopharyngeal swabs and blood testing for SARS-CoV-2 IgM and IgG antibodies; (c) use of continuous personal protective equipment at the NICU by parents and staff. A total of 6726 triage procedures were performed on 114 parents, and 954 nasopharyngeal swabs were collected from 226 individuals. Five (2.2%) asymptomatic individuals (2 parents and 3 healthcare providers) tested positive on nasopharyngeal swabs and were kept isolated for 14 days. Of 75 admitted newborn, no one tested positive on nasopharyngeal swabs or antibody tests. Three parents presented with fever or flu-like symptoms at triage; they tested negative on swabs. Conclusion: With universal screening of neonates, parents, and staff, there were no cases of SARS-CoV-2 infection among the neonates admitted to a NICU in an area with a high incidence of SARS-CoV-2. Our experience could be usefully compared with other strategies with a view to developing future evidence-based guidelines for managing high-risk neonates in case of new epidemics. What is Known: • The novel coronavirus named SARS-CoV-2 has since spread worldwide at a remarkable rate, with more than 2.5 million confirmed cases. • Pediatric population may be less affected from COVID-19 than adult population but infants and newborn babies seem to be more vulnerable to SARS-CoV-2 infection. What is New: • Using an approach based on triage; testing with nasopharyngeal swabs and serology; and use of personal protective equipment, there were no cases of SARS-CoV-2 infection among neonates in a NICU in a high incidence of SARS-CoV-2 area. • Positive and asymptomatic individuals were identified and isolated early allowing the containment of infection's spread among healthcare providers and parents.

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Managing a tertiary‐level NICU in the time of COVID‐19: Lessons learned from a high‐risk zone

Cited by 21 publications

References 3 publications

Reshaping neonatal intensive care units (NICUs) to avoid the spread of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) to high-risk infants

Reshaping neonatal intensive care units (NICUs) to avoid the spread of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) to high-risk infants

The Collateral Impact of COVID-19 Emergency on Neonatal Intensive Care Units and Family-Centered Care: Challenges and Opportunities

Universal screening of high-risk neonates, parents, and staff at a neonatal intensive care unit during the SARS-CoV-2 pandemic

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