In the busy world of neonatal intensive care, reusable bottle systems offer numerous benefits for babies, families, and dedicated staff. For years, units have shied away from these consistent, reliable feeding products, dreading the cleaning process, fearing it would be an enormous task.
Let’s debunk this common myth: Satisfying infection control and The Joint Commission is not as daunting as it seems. The truth is hospitals have been successfully using these bottle systems for years, and with the right cleaning approach, it can be as simple as taking a temp. The key – a squeaky-clean policy.
According to The Joint Commission their standards are not written to the level of detail to address specific devices. Rather, they point hospitals to look at guidelines and comply with 1) local, state, and federal laws (e.g., Department of Health); 2) Evidence-based guidelines and national standards (e.g., CDC) and 3)Manufacturers’ instructions for Use (IFU) (Manufacturer Suggested Guidelines).1
Here’s how to create a policy that will have infection control and The Joint Commission nodding in approval:
1. Establish a Written Policy and Procedure
Each unit should develop a comprehensive written policy and procedure for cleaning reusable bottle systems. Most importantly, ensure all staff members are trained on and CONSISTENTLY follow this policy. Even further, staff should know where to find this policy if approached.
2. Follow the Manufacturer’s Lead
Adherence to the Instructions for Use (IFUs) or manufacturer suggested guidelines provided for cleaning is a requirement. Per The Joint Commission, “It is important to understand that each patient care item has its own IFU for cleaning and disinfection and the expectation is that the organization will follow those instructions. Failure to follow such instructions or misuse creates significant risk to safe, quality care.”2 To go the extra mile, some hospitals use visual aids, such as placards listing the cleaning steps according to the manufacturer’s guidelines, to reinforce the cleaning process.
What does a unit do when guidelines and clinical expectations conflict? For instance, take the traditional “boil before first use” instruction. As a guideline, this is not NICU-compatible. In this case, the NICU team is required to devise a different evidence-based policy, and the policy should outline a process to explain the adjusted cleaning policy as a reasonable adaptation.
3. Look Beyond the Steam Bag
A common mistake is preparing guidelines specific to only cleaning bottle systems and nipples. The Joint Commission, as well as the CDC also address how to store infant feeding items. Per The Joint Commission standards, organizations are required to store food and nutrition products, including those brought in by patients or their families, using proper sanitation, temperature, light, moisture, ventilation, and security. 3 The CDC states to “allow clean feeding items, bottle brushes, and wash basins to air-dry thoroughly before storing to help prevent germs and mold from growing. Once the items are completely dry, put them back together and store them in a clean, protected area to prevent contamination.”4 How do you store your reusable bottle systems? Some hospitals report that they store them in cabinets, while others use bins and cover them with a towel or cloth.
By implementing these measures, hospitals can effectively use reusable bottle systems while observing Joint Commission standards. Remember, consistency in following established procedures is key to maintaining compliance and ensuring the safety and quality of care for NICU infants. For more information about cleaning, drying and storing reusable infant feeding products in a hospital setting, join a recorded informative session here.
References/Resources
2. https://www.jointcommission.
4. https://www.cdc.gov/hygiene/
Steele C, Collins E. eds. Infant and Pediatric Feedings: Guidelines for Preparation of Human Milk and Formula in Health Care Facilities. 3rd ed Chicago, IL: Academy of Nutrition and Dietetics; (2018). p. 1–248.
