Hand Hygiene for the Prevention of Infection in Neonates
Hygiene is one of the most prevalent causes of neonatal infections in healthcare facilities. According to Kuti et al. (2019), more than 25% of the neonatal deaths that occur each year can be attributed to sepsis, which is a result of infections. These infections mostly result from the unhygienic handling of neonates such as through exposure to secretions at the birth canal. Other causes of infections among neonates are environmental factors, which are also related to hygiene such as poor hand hygiene among healthcare providers. Various hand hygiene techniques have been identified to help prevent infections among neonates, and the different techniques have different degrees of effectiveness. In this study, an exploration of different hand hygiene techniques that have been commonly used in neonatal healthcare service delivery has been explored based on previous literature. A recommendation is also made for the most effective hand hygiene technique for the prevention of infection in neonates.
Neonatal deaths are a major cause of concern in the healthcare sector in contemporary times, and measures have been put in place to help curb the issue across the globe. The prevalence of infection caused by neonatal death particularly varies across the world, with higher infection-caused deaths in developing countries than in developed countries (Kuti et al., 2019). As such, there has been increasing effort towards reducing in-hospital infections for neonates with one of the recommended actions being on hand hygiene (Ram, 2018). This literature review presents a description of various studies that have been conducted in the past on hand hygiene for the prevention of infection in neonates. It also identifies the gaps that still exist in this subject.
The previous literature for this study was picked using search engines. Only articles from reliable peer-reviewed journals were selected for the study. Various health sciences databases were targeted during the literature search including the Cochrane Library, Medline, CINAHL Complete, and BioMed Central Database. The article searches were conducted using keywords and phrases such as “infection of neonates”, “hand hygiene in caring for neonates”, and “neonates’ infection prevention”. The articles were picked based on various criteria including that they had to be relevant to the study subject at hand; they also had to provide evidence-based solutions to the issue of hand hygiene in caring for neonates. As such, a multi-stage selection process was followed, in which the first step was to explore the content of accessed articles. This was followed by a recursive abstraction process through which the contents from the articles were extracted according to various study themes. The last stage involved the selection of articles that had the greatest fit with the study objectives and various themes.
Handling of neonates has been extensively cited as one of the causes of infections among neonates. In particular, healthcare providers, as well as individuals who care for neonates, have been cited to be a cause of infection due to unhygienic hands. According to Kuti et al. (2019), pre-term infants are most vulnerable to infections. Kuti et al. (2019), further posit that contaminated hands are the most frequent cause of hospital-acquired as well as community-acquired neonatal infections. Hand washing is therefore likely to play a major preventive role with regards to both hospital-acquired and community-acquired neonatal infections (Ram, 2018). Moreover, hand hygiene is also a practical approach for preventive care even among the low and middle-income nations due to its affordability. Therefore, various techniques of maintaining hand hygiene can be identified and utilized within the neonatal care environment. Lam, Lee, and Lau (2004), also conducted another study to establish the impacts of hand hygiene practices on neonatal care. The study was founded on the hypothesis that the frequency of contact between healthcare workers’ hands and infants could influence the prevalence of infections in healthcare facilities.
Handwashing techniques have been recommended for the improvement of hand hygiene among healthcare workers and among neonatal caregivers. Lam et al. (2004) recommended a problem-based and tasked-based educational program for the improvement of compliance with hand hygiene techniques in healthcare facilities. Through the study, it was established that educating care providers on the importance of hand hygiene and reducing the frequency of handling or clustering procedures, can enhance the total exposure probabilities and thus reduce the probability of neonatal infection. Kuti et al. (2019), also emphasize this finding by mentioning that hand hygiene should go beyond the conventional handwashing with soap and water when handling neonates. The authors recommend the use of alcohol-based hand wipes, hand scrubs, and a variety of antiseptic agents such as chlorine derivatives and quaternary ammonium compounds. Hand washing is recommended to be carried out prior to handling any equipment to be used with neonates, in between cleaning equipment and touching the infants, and any time prior to touching neonates.
Hand hygiene is one of the major strategies for reducing infection in healthcare facilities not only among neonates but among all patients. Neonates are however more susceptible to infections and should be handled with greater care, focusing on washing hands any time prior to handling neonates. For the hand washing, more rigorous techniques are proposed for neonates.
Kuti, B.K., Ogunlesi, T.A., Oduwole, O., Oringanje, C., Udoh, E.E., & Meremikwu, M.M. (2019). Hand hygiene for the prevention of infections in neonates. Cochrane Database for Systematic Reviews. Retrieved from www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013326/full
Lam, B.C., Lee, J., & Lau, Y.L. (2004). Hand hygiene practices in a neonatal intensive care unit: A multimodal intervention and impact on nosocomial infection. Pediatrics, 114(5), e565-71. Retrieved from www.ncbi.nlm.nih.gov/pubmed/15492360
Ram, P.K. (2018, May 3). Every newborn deserves caring, clean hands. Global Hand washing Partnership. Retrieved from globalhandwashing.org/8618-2/