Skin protection and breakdown in the ELBW infant. A national survey

Abstract

The purpose of this study was to learn how neonatal intensive care unit (NICU) nurses describe the problem of skin breakdown in the extremely low birth weight (ELBW) infant, examine interventions currently used to prevent and treat ELBW infant skin breakdown, and to learn how nurses describe and measure skin breakdown. Questionnaires were sent to 482 NICUs in the United States, and a response was requested from a registered nurse with at least 2 years NICU experience currently employed in the NICU who regularly managed ELBW infants. Questionnaires were returned from 215 NICUs (45%). Analysis revealed that an average of 21% of ELBW infants suffered skin breakdown during the 1st week of life. Nurses who reported the least problems with ELBW infant skin breakdown followed skin-care protocols that limited use of tape and made liberal use of Aquaphor to protect fragile skin. Recommendations from this study include the development of an objective tool to rate skin breakdown and further study of product efficacy used in the treatment of skin breakdown.