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Bathing a Premature Infant in the Intensive Care Unit: A Systematic Review
Daniel Fernández1, Rebeca Antolín-Rodríguez2
1Department of Nursing and Physiotherapy, University of Leon, Spain.
Insights
Daily bathing of preterm infants in the Neonatal Intensive Care Unit (NICU) can cause adverse effects. The Swaddle bath method is recommended to reduce temperature loss and stress in premature infants.
Area of Science:
- Neonatal care
- Pediatric nursing
- Infant physiology
Background:
- Routine daily bathing of preterm infants in the Neonatal Intensive Care Unit (NICU) can negatively impact infant stability.
- Key adverse effects include decreased body temperature and increased stress, potentially hindering growth and development.
Purpose of the Study:
- To evaluate the effects of different bathing methods on the physiological state of preterm infants in the NICU.
- To determine optimal bathing practices to minimize adverse effects and improve infant outcomes.
Main Methods:
- Systematic review including descriptive and analytical studies in English and Spanish.
- Included studies evaluated the effects of bathing on preterm infants' physiological status.
- Analyzed data from ten articles involving 438 patients.
Main Results:
- Swaddle bathing was associated with fewer temperature fluctuations and lower stress levels compared to sponge baths or tub baths.
- Bathing frequency can be reduced to every 96 hours without increasing infection risk.
- Nurse behavior during bathing significantly influences infant stress levels.
Conclusions:
- Implementing appropriate bathing protocols, particularly the Swaddle bath, is crucial for preterm infants in the NICU.
- Optimized bathing practices can potentially reduce hospital admission, re-entry rates, and improve overall morbidity and mortality outcomes.
Problem:
Daily bathing of the preterm infant in the Neonatal Intensive Care Unit (NICU) is a process that is usually done routinely, but it can cause many adverse effects on the stability of the infant. Highlights include decreased body temperature and increased stress, which can cause alterations in its proper growth and development.
Eligibility Criteria:
We included both descriptive studies and analytical studies that evaluated the effects of bathing on the physiological state of the preterm infants admitted to NICU. The limit on the time of publication was not established and the languages included were Spanish and English.
Results:
Ten articles (438 patients) met the inclusion criteria, of which one was a quasi-experimental trial, five randomized clinical trials, one cohort study and three followed a descriptive design. A comparison has been made according to the type of bath: sponge bath, bathtub and Swaddle bath, showing that the Swaddle bath was less related to temperature changes and stress levels. It was also shown that the frequency of bathing can be reduced every 96 h without increasing the risk of infection. Finally, it has been observed that the nurse's behavior is also closely related to the stress suffered by the premature infant.
Conclusions:
This paper reveals the importance of correctly bathing premature infants as hospital admission, re-entry and morbidity and mortality may be reduced.
Implications:
Swaddle bath has been shown to be the best method for bathing preterm infants in the Neonatal intensive Care Unit.
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