Page 223 - policy and procedure infection control

Policies and Procedures on Infection Control
Appendix C

Measures To Control Nosocomial Infection Outbreak In NICU

In the event of an outbreak of MRSA or Multiresistant organism infection (MRO) in the NICU, the
following measures will be enforced:

1. NICU will be closed for outborn referral until the outbreak is under control.

2. Nurses taking care of patient with MRSA / MRO infection, should not be taking care of patients
who are not infected at the same time.

3. Where it is not possible to place the patient(s) in isolation, patients with multiresistant infections
should be cohorted to the same cubicle as far as possible to prevent cross transmission.

4. Patients without infection but in close proximity to infected infants to be kept in a separate cohort
from new admissions, if space permits.

5. Antibiotic policy to be reviewed if necessary according to the sensitivities of the organisms
involved.

6. Microbiology department to be alerted to help determine source of outbreak and to provide timely
information of cultures sent from the ward.

7. Infection control policies to be reinforced to all staff.

a. Hand washing with antimicrobial liquid soap before and after handling patients is
to be strictly reinforced. Wash hands immediately after handling the patients, before
touching the patient records or X –ray. All staff will be reminded about the proper
technique of handwashing.

b. Hibitane 70% alcohol hand rub will be made available at every patient’s bedside
and can be used as an alternative.

c. Masks and plastic aprons and are to be used whenever handling patients with
multiresistant organism especially whenever there is risk of exposure to body
secretions. These should be discarded after use with each patient.
d. Stethoscopes are not to be shared between patients and should be wiped with
alcohol swab after each use. They should be hung up immediately after use, away
from TPN bags or enteral bags and not be left on patients’ bed or on writing table.

8. Bed linens are to be change at least twice daily or more frequently when soiled with body
secretions.

9. Environment service staff is to look into the cleaning and housekeeping procedures, especially
about the leaks from the air-conditioner.

10. Relatives are to be taught how to wash their hand before and after touching the patient.

11. Screening: While screening for MRSA is not done routinely, during an MRSA outbreak every
NICU patient and staff should be screened for MRSA colonisation.

208 Ministry of Health Malaysia