delay the baths anne marie henri, rn, bsn nurse manager mother baby units boston medical center
TRANSCRIPT
Delay the Baths
Anne Marie Henri, RN, BSN
Nurse Manager
Mother Baby Units
Boston Medical Center
Boston Medical CenterUrban setting (Boston)
Academic teaching hospitalStrong 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
Delay the Bath InitiativeBackground: After birth, a baby’s blood glucose
level reaches it’s 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 (>97.6 ax) achievedWe 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
ChallengesMDs on board with delaying the bath
Staff nurses were not enthused for the following reasons:“Gooky”“Smelly”“Parents will hate it”“Infections”“It’s not the way we do things”
How we did itLots of discussion and coaxing
Finally, we picked a GO dateOn May 10, 2010, the Delay the Bath Initiative
would begin
Baths would be delayed until infant 12 hours of lifeExcept if history of maternal HIV+, hepatitis B or C
positive
Then after the the bath, infant placed skin-to-skin on mother’s chest
Signs were posted
in unit areas
Information
posted in maternity rooms in
three languages
We added a
bassinette card
Our first baby! This mom had C-Sec and insisted on
getting out of bed to give the first bath.
Skin-to-skin after the bath
Skin-to-skin can be with Dad too!
Lessons LearnedChange 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 don’t bathe babies at all