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Purpose of project was identification and guideline development for multiple uses of low air loss (LAL) within the neonatal and pediatric population at a Magnet Designated Children’s Hospital.
Background
Diaper dermatitis is one of the most common dermatological diagnoses in the neonatal and pediatric population. Diaper dermatitis has been identified in 25% of the general diaper-wearing pediatric population [1]. Alteration in skin integrity can cause physical pain and suffering to the child with mental anguish to the parents. Depending on the severity of the dermatitis and disruption in the skin, may result in increased length of stay and additional financial expense.
Objective
The CWON and FNP-C led the guideline development initiative with (1) identification of at risk patients, which would benefit from an alternative support surface, (2) development of guidelines to provide moisture management in the neonatal and pediatric patient population, (3) development of patient algorithm to assess the patients’ Braden Q[2] or Neonatal Skin Condition Score[3], and Neonatal Abstinence Score[4] (NAS). Based on the algorithm outcomes, determination is made if LAL pediatric crib surface is appropriate for integration into the care plan.
Outcomes
Integration of the low air loss pediatric surface was successful with guideline development for primary services that are able to identify at risk patients and early therapy initiation. Use of the LAL pediatric crib surface has steadily increased since inception. Patients with diagnosed moisture associated diaper dermatitis demonstrated improved healing times of one week upon initiation of LAL therapy. A low air loss surface has shown to be effective in interrupting the cycle of contributory events leading to diaper dermatitis. Improved sleep pattern along with a decrease in NAS (from 11-14 to 5-8) have been associated with the integration of LAL for patients diagnosed with Neonatal Abstinence Syndrome.