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Možnosti redukcie nozokomiálnych infekcií u novorodencov

Možnosti redukcie nozokomiálnych infekcií u novorodencov How to prevent nosocomial infections in the Neonatal Intensive Care Unit. Peter Krcho, MD, PhD. How to prevent nosocomial infections in NICU. Neonatal Clinic NICU M F UPJŠ a nd PFH PC Košice Head of the clinic

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Možnosti redukcie nozokomiálnych infekcií u novorodencov

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  1. Možnosti redukcie nozokomiálnych infekcií u novorodencov How to prevent nosocomial infections in the Neonatal Intensive Care Unit Peter Krcho, MD, PhD.

  2. How to prevent nosocomial infections in NICU Neonatal Clinic NICU MF UPJŠ andPFH PC Košice Headoftheclinic Peter KRCHO, MD, PhD. krcho@upjs.sk

  3. Nosocomial infections are common! Gestational age (wks) Late onset sepsis (%) < 25 46% 25-28 29% 29-32 10% > 32 2% Stoll Pediatr. 2002 krcho@upjs.sk

  4. Routine Use of Gowns in the NICU • Practice transferred from policies developed for surgical asepsis during operations • Very limited data to support is efficacy and much data to say it is ineffective**Forfar & McCabe BMJ 1958, Williams & Oliver Pediatrics 1969, Donowitz Pediatrics 1986, Pelke Arch Ped & Adol Med. 1994 krcho@upjs.sk

  5. “Science” of Handwashing • Simple handwashing with soap and water does not reliably prevent microbial transmission and may actually increase it by dispersing bacterial colonies(Meers 1980) krcho@upjs.sk

  6. “Science” of Handwashing • Frequent handwashing may actually transmit more bacteria by affecting skin health & raising skin pH (Ojajarvi et al. J Hyg (Lond)1977) • Damaged skin harbors more pathogens krcho@upjs.sk

  7. Our goals from 2007 • Decrease the incidence of nosocomial infections between the newborns in our NICU • Work on the inplementation of more effective and more simple method of the hands desinfection • Find a method to explane the effectivity of hand desinfection using gel • Dry desinfected hands are the best tool for the prevention of nosocomial infections krcho@upjs.sk

  8. How to implemente the method • Use gel always after stardand hadwashing • If the hands was not contaminated with blood, urine, stool or secretions use only gel for desinfetcion • The compliance of the all staff is crutial • It is also very important to have the gel bedside 24 hours krcho@upjs.sk

  9. DRY HANDS 3 min WASH NO GEL Nurse krcho@upjs.sk 3 min WASH PLUS GEL QUICK WASH

  10. DRY HANDS coming outside 3 min WASH NO GEL Physician JUST GELLING krcho@upjs.sk 3 min WASH PLUS GEL

  11. Comparision of the incidence of NI in NICU between 2008 and 2009 krcho@upjs.sk

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  14. Conclusion • The use of gel is more effective then simple handwashing, especially in situations with overcrowded unit • The interventions must be followed very carefully • In emergency situations the use of gel is more effective then short handwasing krcho@upjs.sk

  15. Continual education needed ! krcho@upjs.sk

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