Behaviours monitoring and infections control in neonatal intensive care unit: how to improve ourselves?


hand hygiene
healthcare-associated infections
infection control
neonatal intensive care unit


Introduction: Healthcare-associated infections are important events in neonatal intensive care unit. Hand hygiene is considered one of the most important procedures to control these complications.

Methods: Healthcare workers procedures for patient’s approaching were directly monitored from February to April 2018 in the Neonatal Intensive Care Unit of Istituto Giannina Gaslini, Genova, Italy. Number and type of total contacts with patients or “patient unit” (e.g.: ventilator, monitor, incubator) were recorded as well as errors related to lack of hand hygiene after and before performing procedures.

Results: A total of 1040 actions were observed on patient or patient unit: 560 actions by nursing staff, 240 by residents and 240 by consultants. The most common misbehaviour was the “double touch” in nursing staff (30%), “glasses, hair or nose” in residents (35%), and “double touch” and “glasses hair or nose” in consultants (25% and 23% respectively).

Conclusions: Extemporaneous contact as the more frequent potential “high risk” moment in patient care in NICU.


Mahieu LM, Buitenweg N, Beutels P, De Dooy JJ. Additional hospital stay and charges due to hospital-acquired infections in a neonatal intensive care unit. J Hosp Infect. 2001;47(3):223-9. doi: 10.1053/jhin.2000.0852

Scott G. Prevention and control of infections in intensive care.Intensive Care Med. 2000;26 Suppl 1:S22-5. doi: 10.1007/s001340051114

Adams-Chapman I, Stoll BJ. Prevention of nosocomial infections in the neonatal intensive care unit. Curr Opin Pediatr. 2002;14(2):157-64. doi: 10.1097/00008480-200204000-00003

WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care. Geneva: World Health Organization; 2009

Bertsch RA. Avoiding upper respiratory tract infections by not touching the face. Arch Intern Med. 2010;170(9):833-4. doi: 10.1001/archinternmed.2010.96

Akinyemi KO, Atapu AD, Adetona OO, Coker AO. The potential role of mobile phones in the spread of bacterial infections. J Infect Dev Ctries. 2009;3(8):628-32. doi: 10.3855/jidc.556

Tatarelli P, Lorenzi I, Caviglia I, Sacco RA, LA Masa D, Castagnola E. Estimation of mean number of daily hand hygiene procedures per patient can represent an effective and easy understandable method to evaluate adherence experience in a tertiary care pediatric hospital of Northern Italy. J Prev Med Hyg. 2016;57(4):E185-9