[Audit "Toys and incubators in neonatology"]

Owing to an increase in nosocomial septicaemias in the Neonatalogy department, we've judged it necessary to consider the role of items not linked to the nursing procedures, and nevertheless present in the incubators, as well as the hygiene techniques applied to them. In November 2007, we've made a longitudinal prospective study consisting in an observation audit during 3 successive days, observing every single incubator with a newborn baby. In each incubator, we've checked whether there were or not items that weren't required by the nursing activities, along with their characteristics and the hygiene procedures applied to them. We've inquired as well whether the parents and the nursing staff knew and applied the required hygiene procedures. In 13 among the 17 incubators under survey, at least one item not strictly required by the nursing procedures could be found. The number of toys in each incubator varied from seven to one. Among the 33 toys surveyed, 24 (73%) of them showed a score of maximum fluffiness (4 out of 4), and only 10 wore labels giving cleansing advice from the manufacturers. Without any record about the cleaning/disinfecting of the toys brought in hospital, we have observed that the parents were given varied advice about how to clean the toys at home before putting them in the incubators (only four parents had washed the toys in their washing machines at more than 30 degrees C). From the six samples under scrutiny, all the culture results were tested positive. In particular two of the soft toys sampled were found infected by a Pseudomonas oryzihabitans. These particular toys belonged to a baby who had been diagnosed with a septicaemia characterized by hemocultures positive to a P. oryzihabitans of a different strain. Our audit has been an efficient reminder that any item put in an incubator is a potential vector and reservoir of pathogen organisms. After a general feedback towards the department staff, the medical staff then prescribed to permanently ban all the items not strictly required by the nursing activities from all the incubators of the department.