Our level IIIunit has had numerous MRSA and SERRATIA outbreaks, all the while management seems to be reactive and not proactive.
I was wondering if there are statistics/research "effect wise" for overcrowded and understaffed nicu's?

I'm not sure on the research, but we go thru ebbs and tides of those nasty little buggers too! A few years ago we had a huge outbreak of pseudomonas.... Ick!

Do you isolate the MRSA/serratia kids? We have to group them together or isolate the whole room...no floating in or out with any kids, that person/s have no admits, can't transport, or change assignments for their shift.

We were isolating the entire NICU. No questions asked. Initially we were cohorting MRSA positive babies but that stopped and we were told to treat everyone the same. But we didn't get the correct PPE to sufficiently isolate all the babes, and MRSA was still rampant when I left.

We cohort the MRSA babies and gown and glove for them. There is no limitation placed on the nurse, she/he can care for other babies and admit, do triage, whatever. We do weekly MRSA swabs on Mondays on every baby and once a baby tests positive, that baby is considered positive for the rest of their stay. Also, we do bactroban ointment to the nares BID and hibiclens baths daily for seven days after they are positive. We just added a new policy to triple dye all cords immediately on admit to the NICU if not already done. Apparently the triple dye has an agent in it that kills the bad bugs. Our neonatologists have no problem putting in lines through a dyed cord.

We no longer have nurses care for positive and negative patients. Now a nurse takes care of only positive babies. No one is supposed to come into that assignment to help out (say to feed a baby, change a diaper, etc...), unless emergent needs arise.

Isolation babies are cared for by one nurse( or more, based on acuity), and that nurse alone. SO if you have 1 isolation baby that's a feeder, he has 1 nurse. It gets boring really quick, but makes sense from an isolation standpoint. We do surveillance swabs on admit, place transports on isolation pending cultures, and surveillance swabs every 1-2 weeks depending on IC's mood. We had a MRSA run last year with 3-4 babies, but haven't had any since. Just a few questionable lesions, etc....

We've just had a few kids with a wierd strain of serratia, which is a waterbug....we know are changing our vent water reserviors every 3 days and ambu bags also. They cultured one of the vents and it had it ....ewww!

We don't cohart the serratias...just precautions.

I think it is scary that we are starting to see all these resistant bugs in NICU's...or odd strains. Makes you wonder about how we are going to treat things in the future, doesn't it?