Neonatal Skin Care: Evaluation of the AWHONN/NANN Research-Based Practice Project on Knowledge and Skin Care Practices

Lund, Carolyn; Kuller, Joanne; Lane, Alfred T.; Lott, Judy Wright; Raines, Deborah A.; Thomas, Kerry

doi:10.1111/j.1552-6909.2001.tb01519.x

Cited by 58 publications

(24 citation statements)

References 26 publications

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“…DD can occur in diapered and/or incontinent patients of varying ages. Neonates, specifi cally premature neonates, are at increased risk (Lund et al, 2001), as well as patients between 9 and 12 months of age (Jordan, Lawson, Berg, Franxman, & Marrer, 1986). DD commonly affects healthy children; however, acutely and chronically ill children may be at higher risk due to factors including medications that can cause diarrhea, underlying diagnoses such as cancer, gastrointestinal anomalies, neurological disorders, genetic syndromes, and malnutrition.…”

Section: Synthesis Of Literature and Additional Evidencementioning

confidence: 99%

“…Appropriate application of prevention and treatment products is also an important factor to consider. Several experts (Lund et al, 1999(Lund et al, , 2001Taquino, 2000) advise caregivers to apply barrier products thickly and refrain from rubbing off completely during diaper changes to prevent further skin damage. Covering barrier products with a thin layer of petrolatum may help prevent the diaper from sticking to the product (Borkowski, 2004).…”

Section: Synthesis Of Literature and Additional Evidencementioning

confidence: 99%

“…Baldwin also found that an increased concentration of zinc oxide in an impregnated diaper led to an increased transfer of zinc oxide to the skin. Hoggarth et al (2005) Davis et al, 1989a;Lund et al, 1999;Nield & Kamat, 2007;Scheinfeld, 2005 a Application procedures for use of barrier products & antifungal products Borkowski, 2004;Gray, 2007;Lund et al, 1999Lund et al, , 2001 Based on the feedback, many nurses were unaware of our current standard or had read it once during orientation and had not accessed it again. Primary obstacles were inaccessibility, including diffi culty searching the nursing intranet or having no direct links to the standard.…”

Section: Current Practicementioning

confidence: 99%

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Heimall

Storey

Stellar

et al. 2012

McN: The American Journal of Maternal/Child Nursing

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Diaper dermatitis (DD), an acute inflammatory reaction of skin in the perineal area, is an extremely common pediatric condition. Nurses' practice of preventing and treating DD is inconsistent and often not evidence-based. In addition, a 2008 Skin Injury Prevalence Study at our hospital revealed that 24% of inpatients had DD. The authors developed a project to determine a consistent and evidence-based approach to DD prevention and treatment including the availability of products. A complete literature review was conducted in addition to benchmarking with other pediatric hospitals, consultation with topic experts, and evaluation of current nursing practice prior to revising the existing perineal skin care nursing standard. The evidence supports frequent diaper changes, use of super absorbent diapers, and protection of perineal skin with a product containing petrolatum and/or zinc oxide. As supported by the literature, we revised the standard to include improvements in practice as well as product updates for prevention and treatment. Hospital-wide implementation of the revised standard included training "Skin Care Champions" to educate staff and support practice improvements. Ongoing education and monitoring by the Skin Care Champions is necessary to further improve the prevention and treatment of DD for our patients.

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Section: Synthesis Of Literature and Additional Evidencementioning

confidence: 99%

Section: Synthesis Of Literature and Additional Evidencementioning

confidence: 99%

Section: Current Practicementioning

confidence: 99%

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Beginning at the Bottom

Heimall

Storey

Stellar

et al. 2012

McN: The American Journal of Maternal/Child Nursing

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“…Preservar a integridade da pele é um importante aspecto da assistência de enfermagem neste período neonatal de transição. 11 A assistência intensiva na UTIN contrapõe-se à necessidade do manuseio mínimo para melhorar a qualidade de vida dos RN, principalmente quando da realização de procedimentos invasivos. Estes, associados ao uso de antissépticos, às vezes excessivos, porém sempre importantes para a terapêutica dos RN, podem muitas vezes ser potenciadores do surgimento de lesões, reafirmando a pertinência do cuidado individualizado.…”

Section: Resultsunclassified

Cuidados com a pele do recém-nascido: análise de conceito

Fontenele¹,

Pagliuca²,

Cardoso

2012

Esc. Anna Nery

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O foco do enfermeiro é o cuidado ao ser humano e, em neonatologia, o cuidar da pele do recém-nascido é prioridade. Objetivou-se analisar o conceito de cuidado com a pele do recém-nascido. Referencial teórico metodológico utilizado: Modelo de Análise de Conceito de Rodgers, que permitiu analisar os antecedentes, atributos e consequentes do conceito estudado. Identificaram-se os antecedentes: prematuridade, risco de infecção, monitorização, fatores ambientais, alterações fisiológicas, antissépticos, assistência intensiva, procedimentos invasivos, lesão, exame físico e baixo peso. Atributos: contínuo, individualizado, dinâmico, eficaz, criterioso, delicado, humanizado, seguro, integral, prioridade, imediato e padronizado. Consequentes: previne lesões, mantém a pele íntegra, melhora a condição da pele, o quadro clínico e a circulação, controla as perdas de água, previne infecção e proporciona conforto.. Este método oferece um suporte na consolidação do conhecimento. O conceito analisado revelou importante associação com a prematuridade e risco de infecção, relacionando-se com as características ao longo do tempo.

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“…In 2007, the Second Edition of the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN) Neonatal Skin Care Evidence-Based Clinical Practice Guideline recommended that caregivers use mild cleansing bars or liquid cleansers that have a neutral pH (5.5 to 7.0) 16. The Second Edition of the AWHONN Guideline also recommended that caregivers give preference to preservative-free products or products that contain preservatives with a demonstrated safety and tolerance profile 16. In contrast, the National Institute for Clinical Excellence clinical guideline 37 on postnatal care states that a cleansing agent should not be added to a baby’s bath water unless it is a mild nonperfumed soap 17.…”

Section: Discussionmentioning

confidence: 99%

Tolerance of skin care regimen in healthy, full-term neonates

Iarkowski¹,

Tierney²,

Horowitz³

2013

CCID

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PurposeTo assess the tolerance of a baby cleanser and lotion (both lightly fragranced) on healthy, full-term neonates.Materials and methodsTwenty-six infant–mother pairs were enrolled in a 6-week, nonrandomized, controlled-use study that took place in the routine setting of a pediatric clinic and mothers’ homes. During study weeks 1 to 6, neonates were bathed by their mother with water and a test cleanser (JOHNSON’S® HEAD-TO-TOE® Baby Wash). During study weeks 1 to 3, mothers also applied test lotion (JOHNSON’S® Baby Lotion) to the babies’ skin immediately after bathing and one to three times/day on bathing and non-bathing days. During study weeks 4 to 6, no lotion was applied. At baseline and weeks 3 and 6, the infants’ pediatrician or mother or both performed visual skin assessments.ResultsTwenty-three infant–mother pairs completed the study. The mean age of neonates at enrolment was 17.4 days (range, 13–28 days). Pediatrician observations found no clinical signs of irritation, erythema, or dryness with any significant difference in scores of these parameters compared with baseline throughout the study. Assessment of skin softness, smoothness, dryness, and overall skin condition was very good at baseline and remained so with minimal changes throughout the study. Mothers reported improvements versus baseline (P ≤ 0.05) in overall skin appearance, moisturization, softness, and smoothness on the arms and legs at weeks 3 and 6. A total of four (15.4%) subjects experienced adverse events. For three of the subjects, the investigator suspected that the adverse events were unrelated to either of the test products. In one participant, the cause of the adverse event could not be determined.ConclusionThe use of a lightly fragranced nonstinging baby cleanser, with or without a lightly fragranced baby lotion, was well tolerated by newborns and resulted in observable skin benefits per the pediatricians’ and mothers’ assessment.

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Neonatal Skin Care: Evaluation of the AWHONN/NANN Research-Based Practice Project on Knowledge and Skin Care Practices

Cited by 58 publications

References 26 publications

Beginning at the Bottom

Beginning at the Bottom

Cuidados com a pele do recém-nascido: análise de conceito

Tolerance of skin care regimen in healthy, full-term neonates

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