Scrub or handwash?

[Mimi2RN, ASN, RN]

Our visitors have always done a 3 minute scrub when they come in to visit their baby. They also had to wear a covergown. Now we have been told that they don't need covergowns, and scrubbing isn't important either. A quick handwash will do.

What happens in other NICU's? We don't keep babies less than 26/27 weeks, but we do have some very fragile ones on vents. Our acuity level has been going up, and also our numbers are increasing.

[BittyBabyGrower, MSN, RN]

We haven't worn cover gowns for many years. Our parents just have to wash their hands before they handle the baby. We haven't had an increase in infection...just make sure everyone is very good at handwashing. We don't even gown for the 23 weeks, unless they have a low ANC and need to be on reverse isolation. The only kids we gown for are MRSA or VRE.

[prmenrs, RN]

Same here. I'd recommend a slightly more than "quick" handwashing, though. One rationale is that the germs the parents have are the germs they go home to.

If a dad comes from work really filthy, mechanic, etc, I might put a blanket between him and the baby, and suggest [gently] that he clean up a bit before coming to the hospital.

[nikiw]

Anyone entering our NICU has to scrub for 3 minutes before coming in. If parents/visitors refuse to scrub, they are asked to leave. They are also encouraged to wash hands before and after holding/caring for their infants.

[baby&mommynurse]

Our NICU requires a 3 minute scrub up to the elbows. Parents must also wear cover gowns if they are going to be holding their baby. In our normal Newborn Nursery, a cover gown is not required, however they are required to do that same 3 minute scrub each time they enter the nursery regardless of how long they'll be in... even if they have to step back out for a second because they forgot their camera or something. Since the sinks in our newborn nursery don't have the automatic water shut off after 3 minutes like in the NICU, some fathers try to sneak a quick wash. I always bust them and send them right back to scrub longer and lecture them on the importance of hand washing.

[LilPeanut, MSN, RN, NP]

A thorough handwashing, but nothing more than that, no cover gowns, unless there was some mitigating circumstance.

one I shadowed at required the three minute scrub.

[KRVRN, BSN, RN]

We have signs up that parents should wash for 3 minutes. Just a wash, not a scrub with a brush. I know that every parent doesn't do a full 3 minutes, but it gets the point across that a thorough handwashing is necessary. Heck, our staff isn't even required to do a 3 minute scrub or use brushes. We do just a 1 minute wash up to the elbows.

We don't require cover gowns either. But like prmenrs said, if dad is really dirty then we'll ask him to use a gown. They never seem to have a problem with it. Also, our staff doesn't gown for any baby unless it's in isolation.

If parents have twins, we also encourage them to wash between the babies. Although by the time the babies are to the feeder/grower stage I don't really think it's as much of an issue since they frequently hold or breastfeed both babies at once and will be caring for both at home anyway.

[baby&mommynurse]

We don't require cover gowns either. But like prmenrs said, if dad is really dirty then we'll ask him to use a gown. They never seem to have a problem with it. Also, our staff doesn't gown for any baby unless it's in isolation.

We don't wear cover gowns for doing vital signs or assesments, but we do if we have to feed a baby. We make our volunteers scrub as well and wear a cover gown for each baby they pick up to cuddle or feed.

[dawngloves, BSN, RN]

I've worked in 3 NICUs. All three required a three minute scrub, only one cover gowns.

[Gompers, BSN, RN]

Both NICUs I've worked in required 3 minute scrubs up to the elbows for anyone entering the unit - staff, parents, docs, x-ray, housekeeping - everybody. After the initial scrub, just handwashing or hand gel is used by both parents and staff. One hospital used cover gowns (actually just hospital gowns, not even isolation gowns) and the other doesn't use gowns.

[Mimi2RN, ASN, RN]

Thanks for all the replies. It's nice to know how things work in other places.

I wish they would keep the cover gowns (they are just hospital gowns, too). Some people are grubby when they come in, and some are just inappropriately dressed. We had a big sister to one baby who was dressed to kill, with a skirt just below her crotch. Another time we had a daddy who wore his boxers for show, with pants drooping and his belt below his buttocks. I'll be glad when that fashion changes!

We also have moms without bathrobes, we give them a gown to wear backwords, after they have walked all the way to the nursery open at the back. I think we'll have to remind pp to get the moms to cover up.

[premies_4_40yrs]

Everyone entering the unit does a three minute scrub with a brush. We have Purell containers on the wall at each bedside; and parents of multiples are encouraged to use it between babies. We haven't had visitors to the unit wear gowns for about 5 years. We would ask a parent with soiled clothing to wear a gown, though. We also don't allow any outside visitors, wearing scrubs, to enter the nursery without scrubbing and putting on a gown. We had a MRSA outbreak a few years ago, that was traced to a grandmother who worked in a nursing home and would come in to visit her grandson wearing her scrubs.