2202-B - Performing Gap Analysis of NICU Environmental Cleaning Practices

Session Description: Environment of care, including cleaning and disinfecting of rooms and patient care equipment, is a hallmark of preventing transmission of pathogens in healthcare facilities. Improper cleaning and disinfecting practices contribute to device related infections and outbreaks. Neonatal Intensive Care Units (NICU) pose a unique challenge for environmental cleaning practices as neonatal incubators have historically been the source of Methicillin-resistant Staphylococcus aureas outbreaks due to the warm and humid environment the incubator creates along with intricate hard to clean surfaces, multiple layers and compartments, and lack of training for staff. Performing a gap analysis of NICU environmental cleaning practices, including the incubators, is essential in prevention of hospital acquired infections and protection of such a vulnerable, immunocompromised patient population.

This session will describe best practices for cleaning incubators and how to perform a gap analysis of cleaning practices. Examples of common fallouts related to cleaning incubators will be reviewed, such as lack of hand hygiene, inappropriate personal protective equipment use, cross contamination while cleaning incubators, and cleaning practices that result in breakdown of equipment. To ensure incubators remain in good working condition and surfaces are intact and cleanable, the importance of using compatible disinfectants will be reviewed. In addition, education on using fluorescent marking spray and ultraviolet lighting can be used to identify gaps in cleaning practices. Formal training, annual competencies, and readily available manufacturer’s instruction for use manuals are critical for cleaning special patient care equipment like incubators and will also be covered.

Supplementary strategies for providing a clean and safe environment of the NICU will also be covered such as routine incubator change, ultraviolet lights to disinfect staff and visitors’ phones, and cleaning of shared equipment. Infection Preventionists at all career stages will benefit from this topic because of its applicability to cleaning practices for intricate equipment.