Hand washing?

Specialties NICU

Published

Specializes in NICU.

Was looking at some NICU videos on youtube and came across this Australian set of videos on one of their NICUs in Victoria. It was great...except for the fact that the nurse was taking care of this 24 weeker WITHOUT GLOVES!

Now, I'm still a brand new nurse, only 4 months out, on orientation at a level 3 (although I guess some people call it a level 4). And I worked in school on a level 3 with nothing more complex than vents. So my exposure to the NICU culture isn't that much. In my months of working, though, I would be absolutely horrified at the thought of not wearing gloves. In fact, at my facility, we gown up as well, "protective isolation" for kiddos under a kilo.

But maybe this is the norm in some other facilities. I've recently learned that some level IIs don't even put their infants on monitors. Man, if my kiddos weren't on monitors, I would be so nervous and probably wouldn't leave their bedsides, because you never know when that supposed healthy/turning-the-corner kid crumps.

So...I don't know. Do you guys always wear gloves and wash/gel before/after you touch your patients? Or am I just naiive?

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Specializes in NICU.

I wash or use gel before and after patient contact, but I don't wear gloves every time I touch a patient. And we don't gown up for micros...we do change all lines using sterile technique, however.

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A lot of people I work with will wear gloves when working with micros, but it's not required. Universal precautions unless otherwise necessary :)

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Specializes in Neonatal nursing (paediatric trained).

Our unit had started using handwashing and also gloves for every single time you come into contact with a baby a few years ago. However, we started using this new soap back in August that is hell on hands. So, while we still have to wash our hands with soap or alcohol gel before contact, we now only have to glove up if we're coming into contact with bodily fluids.

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Specializes in NICU Level III.

We use Purell + gloves for every pt contact .. both NICUs I've been at do this.

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Specializes in Level III NICU.

We wash our hands or use the alcohol foam before and after patient contact, but we don't use gloves every single time we have to touch a patient. Just for the times when we might be in contact with bodily fluids (diaper changes, IV starts, heel sticks, etc.). We don't gown either, unless the baby is on isolation for some reason.

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Specializes in Medical, Paeds, Ob gyn, NICU.

I work in a Level II NICU in Queensland Australia.

We wash our hands or use gel before and after each patient contact.

The only time we would use gloves is for doing any procedure that involves blood.

We do not use gloves for nappy changes.

That is of course unless the neonate is on contact precautions ect...

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Specializes in CTICU.

No gloves to change a diaper? That's just gross.

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Specializes in NICU.

It's no longer required in our unit to wear gloves with patient contact. The thought there was that some people were skipping Purell and soap/water when they were wearing gloves. Personally, I still wear gloves mainly out of habit, but I also think it's kinda dumb to do everything and then have to pause to put gloves on before changing the diaper. If I'm only touching the baby to replace a paci, temp probe etc then I don't wear gloves unless it's a sweaty/drooling etc baby.

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Specializes in NICU Level III.
It's no longer required in our unit to wear gloves with patient contact. The thought there was that some people were skipping Purell and soap/water when they were wearing gloves. Personally, I still wear gloves mainly out of habit, but I also think it's kinda dumb to do everything and then have to pause to put gloves on before changing the diaper. If I'm only touching the baby to replace a paci, temp probe etc then I don't wear gloves unless it's a sweaty/drooling etc baby.

It isn't? Awesome! I did get barked at by my preceptor because I was repositioning a kid w/o gloves... guess not everyone is up to date on the policy. If I'm just stimulating a kid, I don't have time to Purell and let it dry alllll the way so I can get gloves on without them getting stuck in half wet Purell...all while the baby is bradying or something.

I'm ready for an up to date policy abou the line changes...sooooo ready because everyone says different things with it.

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Specializes in NICU.

Well, in emergency situations, you do what you have to do...

Maybe my NICU is very conservative, from the replies that I've gotten here. We also don't give nurses a patient with MRSA or Cef with a patient doesn't have one and you're not supposed to help out the nurse if you are with a MRSA patient, unless, again, it's an emergency.

Due to this, we've only 1.5 MRSA transmissions per thousand patient days and not a single one in the last 10 weeks, according to the weekly swabs that we send out.

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I think I've seen those videos on YouTube too - there's one where she puts an NG tube down and is handling the baby with her bare hands and big fake nails :confused: I'm pretty sure our official policy is Purell or wash hands then gloves before patient contact. Maybe I'm paranoid but I wear gloves for pretty much everything - the few scenarios I can think of are when a kid is bradying and needs some stimulation or if I'm doing something with tape or leads where I'll just end up getting entangled if I'm wearing gloves. I've occasionally seen nurses not wearing gloves for simple things like repositioning but most of us wear gloves pretty frequently.

It would be interesting to see the evidence for some of these protocols. It's just hard for me to imagine not wearing gloves!

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