1. NICU Educators

2. Early onset neonatal infections Within the first 72 hours of life Manifest – pneumonia and/or septicaemia Incidence = in gender High mortality 10-30% Usually acquired from the birth canal eg Group B Strep (80%) Risk factors Prolonged membranes Preterm Maternal pyrexia UTI, gastro

3. Late onset sepsis (after 72 hours) Organisms acquired around the time of birth or in hospital eg neg staphylococcus Male predominance <1000 grams are particularly at risk Mortality rate >5% >70% - Coagulase negative Staphyloccus & Staphylococcus aureus 10-15% gram negatives Candida particularly in ELBW Long term impairment

4. BPD, proven sepsis, ROP, brain injury

5. N=192 < 30wk

6. 24-27wk babies, n=541 Multicentre swiss cheese Schlapback Ped 2011

7. Features of late onset sepsis Cross infection by staff and parents Prolonged hospitalisations eg preterm Presence of foreign bodies eg. IV, ET, PICC Malformations such as neural tube defects

8. How infection is transferred HANDS! Health Care Workers Rotating personnel Persistent carriers Acute infections staff/visitors Frequent handling Hand Hygiene : 80% of transmission of hospital infection is by contaminated hands!

9. June 2015 hand hygiene

10. NICU hand hygiene June 2015

11. How do you stop contamination?

12. Entering the patients space

13. Step 2 roll up the cover

14. Step 3 open door

15. Step 4 gel

16. Step 5 touch baby

17. Step 6 - Gel

18. Gel, Baby, Gel I am worth it!