Skin care practices in the neonatal nursery: a clinical survey.

OBJECTIVE: To survey the details of skin care practices in a sample of level I, II, and III nurseries in the United States.
DESIGN: A survey conducted by written questionnaire, personal inspection, and phone contact. PARTICIPANTS: Information was obtained from staff physicians and nurses about routine neonatal skin care practices, including bathing, cord care, emollient use, diapering, use of antimicrobial skin preparations, management of intravenous infiltration, approach to diaper rash, and methods used to minimize transcutaneous water loss.
SETTING: Fifteen nurseries from twelve hospitals in four states were surveyed.
RESULTS: Among the nurseries surveyed, we found no uniform approach to skin care. Only two individual maneuvers were consistently performed in all the nurseries: criteria for bathing and skin antisepsis with povidone-iodine. Other than these, a wide range of practices and products were used, some with a high ratio of risk and/or cost to benefit.
CONCLUSION: A better understanding of the principles of infant skin care and a more uniform approach to skin care in the neonatal nursery can minimize risks and costs to this special population of patients.