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Delay the Baths

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Delay the Baths Anne Marie Henri, RN, BSN Nurse Manager Mother Baby Units Boston Medical Center Boston Medical Center Urban setting (Boston) Academic teaching ... – PowerPoint PPT presentation

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Title: Delay the Baths


1
Delay the Baths
  • Anne Marie Henri, RN, BSN
  • Nurse Manager
  • Mother Baby Units
  • Boston Medical Center

2
Boston Medical Center
  • Urban setting (Boston)
  • Academic teaching hospital
  • Strong affiliations with neighborhood health
    centers
  • Births per year About 2,500
  • Maternity unit on two floors
  • 17 (4th floor) and 15 (3rd floor) private rooms
  • NICU Level 3, 12 beds
  • Step Down Unit Level 2, 6 beds

3
Delay the Bath Initiative
  • Background After birth, a babys blood glucose
    level reaches its lowest point at about 2 hours
    of life
  • Our practice for years has been to bathe babies
    at 2 hours of life or when a stable temperature
    (gt97.6 ax) achieved
  • We would sponge bathe the babies body, wash the
    hair under the facet, and then place the baby on
    the warmer
  • With new private rooms came the opportunity to
    bathe babies in their rooms without taking them
    to the nursery
  • Also the opportunity to review the best time to
    bathe

4
Challenges
  • MDs on board with delaying the bath
  • Staff nurses were not enthused for the following
    reasons
  • Gooky
  • Smelly
  • Parents will hate it
  • Infections
  • Its not the way we do things

5
How we did it
  • Lots of discussion and coaxing
  • Finally, we picked a GO date
  • On May 10, 2010, the Delay the Bath Initiative
    would begin
  • Baths would be delayed until infant 12 hours of
    life
  • Except if history of maternal HIV, hepatitis B
    or C positive
  • Then after the the bath, infant placed
    skin-to-skin on mothers chest

6
Signs were posted in unit areas
7
Informationposted in maternity rooms in three
languages
8
We added a bassinette card
9
Our first baby! This mom had C-Sec and insisted
on getting out of bed to give the first bath.
10
Skin-to-skin after the bath
11
Skin-to-skin can be with Dad too!
12
Lessons Learned
  • Change is hard. Discuss, review evidence-based
    practice, discuss again and then at some point
    you just gotta GO
  • Parents love it. No complaints. Great opportunity
    to teach about baths. Great opportunity to
    reinforce importance of and teach about
    skin-to-skin, bonding and breastfeeding
  • Hypoglycemia has almost vanished (?TTN?)
  • Study underway
  • At UCSD they dont bathe babies at all
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