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Designing and Implementing a Skin Care Protocol for Infants With Neonatal Abstinence Syndrome to Decrease Rates of
1Medical University of South Carolina, Charleston.
Insights
Neonatal abstinence syndrome (NAS) infants are prone to diaper dermatitis. An evidence-based skin care protocol significantly reduced diaper dermatitis rates by 80.5% in NAS infants, improving skin integrity.
Area of Science:
- Neonatal care
- Dermatology
- Evidence-based practice
Background:
- Infants with neonatal abstinence syndrome (NAS) face heightened risks of diaper dermatitis, potentially causing pain and infection.
- Current neonatal intensive care unit (NICU) skin care protocols often lack specific strategies for this vulnerable population, leading to inconsistent management.
Purpose of the Study:
- To decrease diaper dermatitis incidence in infants with NAS.
- To design and implement an evidence-based skin care protocol tailored for NAS infants.
Main Methods:
- A retrospective review compared outcomes for 25 infants pre-protocol and 8 infants post-protocol.
- The protocol comprised five interventions: a specific assessment tool, frequent changes with superabsorbent diapers, use of petroleum jelly and alcohol-free wipes, pH-neutral bathing, and zinc oxide barrier cream.
Main Results:
- An 80.5% reduction in diaper dermatitis was observed post-implementation (P ≤ .01).
- The study demonstrated a significant decrease in diaper dermatitis cases among infants with NAS following protocol implementation.
Conclusions:
- Implementing this evidence-based skin care protocol can enhance skin integrity and reduce diaper dermatitis in the NICU.
- Further research is recommended to generalize findings to other NICUs; key takeaways include utilizing a specific assessment tool and consistent intervention bundle.
Background:
Infants with neonatal abstinence syndrome (NAS) are at an increased risk for diaper dermatitis, which can cause skin breakdown and lead to significant pain and potential infection exposure. Skin care protocols in the neonatal intensive care unit (NICU) setting seldom specifically address the needs of this at-risk population, leading to inconsistent skin care management.
Purpose:
The goal was to support a decrease in the rate of diaper dermatitis for infants with NAS by designing and implementing an evidence-based skin care protocol.
Methods:
A retrospective medical record review was used to examine outcomes of 25 infants preintervention and 8 infants postintervention. The skin care protocol was a bundle of 5 evidence-based interventions: (1) a specific diaper dermatitis assessment tool; (2) frequent diaper changes with superabsorbent diapers; (3) application of petroleum jelly and alcohol-free wipes; (4) infant bathing in pH neutral soap; and (5) application of zinc oxide barrier cream for erythema.
Results:
There was an overall 80.5% decrease in diaper dermatitis from pre- to postimplementation (P ≤ .01) as noted when comparing positive cases of diaper dermatitis with negative cases from pre- to postintervention.
Implications For Practice:
Expanding the skin care protocol to all neonates in the NICU and nursery could aid in maintaining skin integrity and decreasing diaper dermatitis in the NICU. More research is needed following this study for the data to be generalizable to other NICUs. This study offers key takeaways including using a specific diaper dermatitis assessment tool and consistently using the bundle of interventions.
Video Abstract Available At:
https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=47.
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