Delay the Baths - PowerPoint PPT Presentation

Anne Marie Henri, RN, BSN

Nurse Manager

Mother Baby Units

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

• Background: 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) 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

• MDs 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”

• 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 mother’s chest

• 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 don’t bathe babies at all