An Organization-Wide Initiative to Implement Parent-Performed, Delayed Immersion Bathing.

OBJECTIVE

To implement an organization-wide evidence-based practice change to parent-performed, delayed immersion newborn bathing across nine facilities at a military health care system.

DESIGN

Organization-wide evidence-based practice initiative using preimplementation and postimplementation data.

SETTING

A military health system consisting of four medical centers and five community hospitals that averages 4,000 births each year.

PARTICIPANTS

Term newborns (≥37 weeks gestation) born within the nine facilities.

INTERVENTION/MEASUREMENTS: Champions were identified at each facility to change bathing practice. Baths for newborns were delayed until 24 hours of age, unless otherwise requested. Parents were instructed how to tub bathe their newborn and encouraged to complete the bath in less than 5 minutes. The team reviewed 100 records from each hospital and compared pre- and postimplementation temperature data.

RESULTS

The organization-wide practice change showed a statistically significant association between time point (i.e., before vs. after implementation) and postbathing hypothermia (χ2 = 30.91, p < .001). In addition, data also showed fewer hypothermic temperature readings (i.e., <97.7 °F [<36.5 °C]) from the onset of birth until 8 hours of life with the new bathing process. Although this difference was not statistically significant (p = .11), it holds clinical significance if it can be replicated; newborn hypothermia requires provider notification and can lead to additional testing to rule out infection and other concerns.

CONCLUSION

Delaying newborns' first bath was associated with a significant decrease in the number of newborns who had hypothermic temperature readings immediately after the bath. The intervention involved minimal cost with multiple benefits. Delayed immersion bathing is a family-friendly process that can be implemented across an organization.