skin to skin with UVCs

[marpcurn]

I am working on a CLABSI (central line associated blood stream infection) project for my unit and I need to know if your unit allows preemies with a UVC line to do skin to skin care..... why or why not.

I cannot find anything in the literature about this specific topic. The literature does support nursing to wear gloves when caring for a preemie with UAC/UVC to prevent CLABSI, so do you think it is acceptable to have your UVC and umbilical stump in contact with mom/dad's bare skin for any amount of time? (think of the last time your peeled a baby off a sweaty parent) I know and love the benefits of skin to skin care, but also want to protect my patients from infection!!

Also, if you have any links to any literature that supports your policy/philosophy that would be wonderful!

[24gaDalek]

I have worked at two different NICUs, neither of them had a no holding policy for UAC or UVC. It really was up to nursing judgment. Me in particular, I would not be comfortable with skin to skin with either unless there was a lot of management of lines involved and unrestricted access for me to visualize and assess the stump frequently. As I am answering this I am thinking of these moms who come down in a tiny tank top and want to have the baby tucked into their shirt and it usually ends up being a cluster f*** trying to make it work managing all the lines and cords all the while trying to help other patients and their families while this is going on. While I do think S2S is extremely important, I think we NICU nurses are set up to fail by the pressure of trying to make it happen when it is not always appropriate. I can think of one mom of a 25 weeker who came to the bedside wanting to do S2S between all cares while her very sick baby was vented, on tons of drips, and struggling to hang on and really not tolerating anything other than being left alone. Mom ended up reporting the day shift nurse to management for asking that the infant be allowed to rest unfettered between care times for "not allowing me to properly bond with my baby." She had done her research and was correct in her assertion that S2S is wonderful for infants, but nowhere in her literature was the discussion that there are infants who CAN be S2S but not necessarily SHOULD be.

As far as for infection control, at one hospital the stump and a small loop of UVC/UAC was covered in Tegaderm..so not quite as exposed.

[NicuGal, MSN, RN]

If moms come in anything other than a button down shirt, and the kid is tubed, etc, no skin to skin.

Tegaderm over the stump doesn't let it dry out and keeps it goop, I'd think that would increase the infection rate.