Date of Graduation

Fall 12-17-2021

Document Access

Restricted Project/Capstone - USF access only

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Program

MSN project

Abstract

Abstract

Problem: In an effort to maintain the privacy of the institution in which the change was implemented, I will refer to the institution as “Children’s Hospital A”. The implementation of immersion swaddle bathing within the postpartum units at Children’s Hospital A aims to utilize evidence-based practice to provide better healthcare outcomes for newborns, in addition to positive physiological response, increased family centered care and overall patient satisfaction. Swaddle immersion bathing is currently used in both the Intermediate Care Nursery (ICN) as well as the Neonatal Intensive care Unit (NICU). In addition to the evidence that supports swaddle bathing, there is a need to standardize the process throughout all neonate-involved units within the institution. Lastly, the project aims to change the current bathing policy at Children’s Hospital A, allowing certified Nursing Assistants to perform all infant bathing.

Context: This quality improvement project utilizes evidence-based practice to initiate and assist in the implementation of Swaddle Immersion Bathing in the maternity units at Children’s Hospital A. This quality improvement project was welcomed by a majority of staff as they were surveyed to reveal that more than 50% of staff was less than satisfied with the current bathing practice. In addition, it was noted that 87% of survey participants agreed that certified nursing assistants (CNAs) should be able to perform first time baths for newborns. Lastly, there was an overwhelming need to standardize the bathing process in all newborn care areas as the current practices did not align with current best practices. This increased the need for change in alignment with research and current evidence-based practice.

Interventions: Within the ICN and NICU, a standardized process is not being utilized. This not only leads to parent confusion but also goes against current evidence that supports bathing the infant in a specific standardized sequence to ensure temperature regulation and stability. This project aims to implement swaddle immersion bathing in the postpartum units in addition to standardizing the bathing process and increasing nursing assistants’ scope to allow them to perform first time baths.

Measures: Measures for the implementation of swaddle bathing are designed to capture overall staff, patient and family satisfaction. These measures will be captured through staff surveys, as well as patient surveys to identify the increase in patient satisfaction after adopting the new bathing method that focuses on family-centered care. Because this new bathing process allows for increased family involvement and education, it is predicted that satisfaction rates will increase.

Results: Successful implementation of education to CNAs and RNs was completed. Unfortunately, Due to time constraints, the team was unfortunately unable to survey staff to assess the successes and areas for improvement within the project. The current project team hopes that this project will continue to be worked on in the future. It is suggested that whomever carries on with the project, continues to offer hands-on training, as well as troubleshoot any pieces of the new processes that might not be working well for staff, patients and their families.

Conclusions: As detailed in the literature review portion on this paper, swaddle bathing is less-time consuming than sponge bathing while also being considerably less stressful for the neonate and the parents. This in turn leads to greater satisfaction for hospital staff and families. Swaddle bathing provides a crucial education opportunity for parents that provides them with confidence and reassurance that they can take home with them. Swaddle bathing should lead to increased staff satisfaction as the process is now standardized and can be delegated to more staff members creating teamwork and efficiency within the units.

Keywords: Newborn, infant, postpartum, NICU, neonatal intensive care units, baby, bathing, swaddle bathing, immersion bathing, turtle tub, maternity, swaddle immersion bathing, first-time bath, neonatal, neonate, family-centered care

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