Infection control overkill?

[BabyLady]

My NICU has banned the practice of wearing simple wedding rings...even though we already have the practice in place of wearing gloves anytime we practice infant care as well as a 3-minute hand scrub when you enter the unit. Touch an infant = wearing gloves.

Personally, I find this offensive and there was no outbreak of anything recent that led to this practice...every time we have had anything to spread, it has always been traced back to lack of handwashing/glove wearing practice.

Does anyone else find this overkill? I am so infuriated I am almost tempted to refuse to remove mine...based on the fact that other people from other units, ie. techs, physicians, physical therapists, etc...still wear theirs when working with our patient population.

[NICU_babyRN, BSN, RN]

We have a strict "NOTHING below elbow" rule, no long sleeves, no lab coats, warming jackets for ANYONE who is coming in contact with infants. The few nurses who try to break this on the night shift regret doing so. The gels and foams wear at your rings over time, and it really irritates the skin. So no simple or ornate bands for us. And GLOVES gloves gloves for almost all contact.

[walkingrock, ADN]

Our policy is gloves when touching baby; I think it is not very developmental-friendly for the babies. Of course, handwashing after gloves removed and before touching anything being used on the baby. We do not use gloves when touching our computers (charting). We have a 15 sec. scrub with approved soap & water or waterless hand cleaner, to the elbows, but don't take off rings, watches, etc. We aren't supposed to wear any clothing below the elbows when doing infant cares. I don't expect our policy to change anytime soon, but thinking there might be less skin problems and nicer for the babies without all the gloves. However, a big hurtle for everyone to take off rings and watches....It would be interesting to see a study of which method was more effective in decreasing the infection rate. It would have to be a large study, as there are significant differences in units in different locations, and variences of acuity and types of infants...

[aerorunner80, ADN, BSN, MSN, APRN]

My main question would be if this would be develpmentally appropriate or not. Humans and babies NEED skin to skin contact. Why do we think kangaroo care works so well?

There are times, IMHO, where an infant needs some skin to skin contact such as a hand on the back and/or head to help calm them down when they aren't able to calm themselves.

[littleneoRN]

Kangaroo care works for a myriad of reasons, most of which aren't applicable to touch with hands. And from an all-gloved unit, I can vouch that a gloved hand still calms a fussy, disorganized preemie. I realize that there are those kids who don't have parents there much or at all, but generally I think the skin to skin contact is covered by the parents. It comes down to choosing priorities, and given our population, I think prevention of infection needs to be a high priority.

I think there have been studies of effective handwashing methods. It doesn't need to involve different units with different types of babies, or even nurses. They just culture people's hands before and after washing. No question that having rings or watches on during washing reduces the overall effectiveness. I have a hard time understanding some people's strong resistance to removing rings and watches at work. Our unit has done this for years, and everyone is fine with it.

[hikernurse]

I guess the thing is that gloves aren't sterile. They just wait in opened boxes for us to grab them. The same germs that are on our hands land on the outside of gloves. Of course we use hand hygiene before grabbing gloves, so our hands are clean before we touch them, but still....

Babies on precautions and very small ones of course need the extra protection of gloves, but I am still an advocate of skin to skin touching. We have several parents who aren't able to come in regularly and while I draw the line at kangaroo care with my patients , I do think that human touch is important. Besides, I think nurses who constantly wash their hands (and is there any other kind?, LOL) are probably less of an infection risk than parents who visit after caring for their sick toddler at home.

[SteveNNP, MSN, NP]

Let's all remember that gloves are there to protect the NURSE, not the patient. Handwashing and purell protects the patient.

[BittyBabyGrower, MSN, RN]

True true Steve. The non surgical gloves are somewhat permeable so it is very very important to wash or purell before putting gloves on. We have to wash in and wash out of each bed spot.

[littleneoRN]

We wear gloves to protect the nurse and patient. We glove for all patient contact (and wash before and after of course), which reduces trnsmission of germs patient to patient and nurse to patient. Research shows that even when people wash their hands, there are usually still bacteria present. Coag negative staph is prevalent on your skin and as you know can cause lethal infections in our population. Fresh gloves aren't sterile, but they DO protect the patient too. We have always been good about hand hygiene, but our infection rates still dropped when we started gloving.

[SteveNNP, MSN, NP]

I've found dirt and dead bugs in newly opened glove boxes. Blech.

[sjc80]

Let's all remember that gloves are there to protect the NURSE, not the patient. Handwashing and purell protects the patient.

So does your facility glove for contact?

[SteveNNP, MSN, NP]

So does your facility glove for contact?

Of course. We also get swabbed for MRSA/MSSA clones once or twice a year (during an outbreak) to see if we've picked up something from our patients.