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“The population we deal with is so vulnerable,” she said. Trisha said strict protocols concerning central lines and ventilators have been set up as precautions to help prevent HAIs. Since NICU babies usually have compromised lung function to begin with, getting an infection in their lungs would make their situation even worse. This can result in decreased oxygenation for the entire body. This mucus coats the inside of the lungs and can decrease the gas exchange. If an infection occurs, it can cause an excess production of mucus. The main function of the lungs is gas exchange: oxygen comes in, CO2 goes out. That is why we have to be so careful with a patient on a ventilator.” An infection in the lungs could easily enter the bloodstream and worsen the patient’s condition. “Gas is exchanged inside the lungs, where blood vessels are near the surface. “When a patient is intubated (on a ventilator), a tube is inserted into the trachea, which is a mucus membrane and an ideal location for pathogens to grow,” she explained. Trisha said ventilators are another crucial tool to keep sterile. Nurses and doctors take numerous precautions to make sure the catheters and entry points are as sterile as possible. The downside to the lines is that they are inserted directly into the bloodstream, so if any pathogens are present it can cause an infection. The benefit to a line being inserted, is that it can be kept inside the patient for longer periods of time, they last longer and they only need to be inserted once for a number of different things. These lines can be used for a variety of things when it comes to neonates: nutrition, hydration, medication administration and occasionally, for our very sick infants, central lines are used for blood draws. In our hospital, Neonatal Nurse Practitioners place the UAC or UVC, a special team of nurses place the PICC lines and a doctor places our Broviacs.” “We also use Broviac lines which can be placed in the neck, chest or groin. Another type of line is a peripheral inserted central catheter (PICC), which is usually inserted in the arm,” Trisha said. “They are placed in the umbilical cord (through the belly button). Trisha explained that central lines can be umbilical artery catheters (UAC) or umbilical venous catheters (UVC). One of these cases occured in the last couple of weeks. In the four and a half years Trisha has worked in the NICU, her unit has only lost two patients where HAIs were a contributing factor. We have protocols in place to prevent both of those,” Trisha said. We have only had one of each in the past couple of years. Central line and ventilator-acquired infections are two problem areas we excel in preventing. “Our unit has done a really good job of preventing hospital-acquired infections (HAIs).

But it seems like no matter how careful those nurses are, dangerous pathogens are bound to slip through the cracks. The neonatal intensive care unit contains the youngest and most fragile human beings who are left in the care of trusted nurses. She is currently a NICU nurse in North Carolina.

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The following individual’s full name has been held back to protect her privacy.

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