Couple of questions...

[NICURN29]

I am wondering if some people can give me some insight into how you do some things in your NICU...

1 - Do you always glove up for routine cares?

2 - When disconnecting/reconnecting feedings to NG tubes, do you swab the port and connectors or wear gloves (or both)?

TIA!

[hl_NICU]

1. We wear gloves to do tasks that are likely to involve baby's body fluids. For babies who are in contact isolation, we gown and glove every time we provide care.

2. For feeding tubes, we clean the ports with sterile saline wipes only when we see them soiled.

[littleneoRN]

We glove for all contact with the patient or their direct surroundings. We only clean our NGs prn.

[nicu4me]

Our ng/og tubes are replaced with new ones monthly. They are cleaned every Sunday on the noc shift. We are supposed to wear gloves with all contact, however, retaping things,etc. It's just not possible. To the post above about cleaning the ng only when they look dirty with sterile saline wipes, I question that because aren't you disconnecting your gavage feedings after each one? We use the same gavage tubing q shift or 8 hours or 4 hours if its a drip and the syringe is a new one with every feeding. When we disconnect when feeding is done, we use sterile water to rinse the tubing out.

[SteveNNP, MSN, NP]

I do wear gloves with isolation pts, when preparing breastmilk, and with possible contact with blood, etc...

That being said, I strongly believe that babies need to feel something other than plastic gloves on their skin.

[HappyBunnyNurse]

I wear gloves for all routine care. When doing a PO feeding in an isolette I will take off the glove from the hand on the back that I use to rub and burp. It may sound crazy but I feel like they eat better. As far as OG tubing we change the extension set each time and put down a new tube every 24 hours. So no cleaning unless dirty. The little ones past that "hate to be touched" phase I try to touch without gloves at least some. I agree they need to feel more than gloves.

[Florida NICU RN]

The only time I wear gloves is isolation (of course), when preparing breastmilk feeds, feeding an infant breastmilk, and when I may come in contact with blood. Sometimes I will when changing a diaper, especially if there's a lot of feces in it.

For NG/OG tubing, I don't clean it whenever I connect a feeding to it unless it's visibly soiled. We change the connection tubing for every feed and q 4 hours if it's a continuous feed. I saw a previous post on rinsing the tubing with sterile water. We don't do that on the connection tubing (since it's replaced every feed) and definitely don't do that to the NG/OG tube to the stomach. No way.

[NicuGal, MSN, RN]

Gloves for diapers, isolated kids, body fluids (ie universal precautions), breastmilk, but they need "human" touch, not gloves :)

Tube feedings, we change our tubes every 5 days and clean the ends if gross. We use the same tubing for 4 hours, we disconnect and rinse in between if bolus feeds, or just change them after 4 hours if on continuous. New syringe for each feed for bolus feeds.

[earthcrosser]

I wear gloves in the event of coming into contact with fluids or when I'm doing meds/feeds/flushing lines. One of my preceptors wears gloves for everything and changes them like 5 or 6 times during "hands on" - and expects me to do the same. Drives me batty. Purell is fine for me when I'm just taking a temp or whatever.

I'll clean it if it's dirty. Otherwise they're swapped out every 21 days.

[dawnebeth]

I only wear gloves when there is a chance of touching blood, wounds, infectious patients, etc. I think the babies need to feel the touch of skin for regular care like handling, repostioning, diaper changes (except of course, a soiled diaper.) Even the tiniest preemies need to feel a warm, real hand on their bodies.

I'd only clean the end of a feeding tube if it was really messy looking. If the baby is on a contiuous feeding, the feeding tube itself is either changed every three days if it is argyle or every month if it is a corpack. The tubing to the food source is changed every 4 hours if it is breastmilk, every 8 hours if is is forumla, and every 24 if is is a kangaroo bag. We certainly flush with water when giving meds, especially thick ones.

Dawn

[Galore]

I saw a previous post on rinsing the tubing with sterile water. We don't do that on the connection tubing (since it's replaced every feed) and definitely don't do that to the NG/OG tube to the stomach. No way.

Why wouldn't you use sterile water in the tube? I don't need to do that very often but for example, I had a baby that was NPO except for meds which were given by NG tube. I used sterile water to flush the meds down, otherwise they'd would be sitting in the tube since there were no feeds running.