Glashan Courtney
Medical University of South Carolina, Charleston.
Adv Neonatal Care. 2022 Feb 1;22(1):35-41. doi: 10.1097/ANC.0000000000000898.
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.
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.
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.
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.
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.
https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=47.
患有新生儿戒断综合征（NAS）的婴儿患尿布皮炎的风险增加，这可能导致皮肤破损，并引发剧痛以及潜在的感染风险。新生儿重症监护病房（NICU）的皮肤护理方案很少专门针对这一高危人群的需求，导致皮肤护理管理不一致。
通过设计和实施基于证据的皮肤护理方案，降低NAS婴儿尿布皮炎的发生率。
采用回顾性病历审查，检查25例干预前婴儿和8例干预后婴儿的结果。皮肤护理方案包括5项基于证据的干预措施：（1）特定的尿布皮炎评估工具；（2）使用高吸水性尿布频繁更换尿布；（3）涂抹凡士林并使用无酒精湿巾；（4）用pH值中性的肥皂给婴儿洗澡；（5）对红斑涂抹氧化锌隔离霜。
与干预前和干预后的阴性病例相比，尿布皮炎的阳性病例显示，实施前后尿布皮炎总体下降了80.5%（P≤0.01）。
将皮肤护理方案扩展到NICU和育婴室的所有新生儿，有助于维持皮肤完整性，降低NICU中尿布皮炎的发生率。本研究之后还需要更多研究，以便将数据推广到其他NICU。本研究提供了关键要点，包括使用特定的尿布皮炎评估工具，并持续使用这一系列干预措施。
https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=47。
