Bringing Evidence Based Skin Care to NICU

Background: WOC nurse team was not historically involved in the care of our infants in our twenty bed level two Neonatal Intensive Care Unit (NICU). The skin care practice in the NICU has been based on traditional practices passed on from nurse to nurse rather than evidence based practice. Premature infants are at high risk for compromised skin integrity due to their fragile underdeveloped skin and moist incubator environment.

Purpose: To promote skin integrity in neonates through evidence based skin care.

Objective: (1) To include a NICU nurse on the Save our Skin (SOS) team acting as a liaison for modeling and resource for staff and (2) To provide education on evidence based skin care and products available.

Intervention:  With the success of the SOS program on the medical floors, the WOC nurse team decided to extend our pressure ulcer prevention program to the vulnerable population of the NICU. We engaged a highly motivated nurse to become the SOS nurse in the NICU. This role includes participation in the monthly pressure ulcer prevalence study, attending educational sessions, and acting as a liaison for peers. One example of the SOS nurses' initiative to educate and motivate her staff was to develop a doll with samples of skin care interventions.  We have provided the needed skin care products and participated in this years’ NICU competency providing education on pressure ulcer prevention, ostomy care, and the role of the WOC nurse.

Outcome:  Since the NICU has been active in our monthly pressure ulcer studies, there has been no pressure ulcers identified in this unit. The SOS nurse and staff now page WOC nurse team with questions and requests for evaluations. This is the beginning of a change in both culture and practice in the NICU to one that is evidence based.