NICU bathing protocols

[meanmaryjean, DNP, RN]

I work in a PICU that does all the open-heart procedures for our 75 bed NICU. The babies transfer to us the night before surgery, spend a fair amount of recovery time with us then return to NICU for discharge preparation / teaching / other issues they might have.

Our NICU, like many others, does not bathe their babies daily. Here's my question: Does your NICU bathe babies in preparation for surgery (of any type) or do they just go to the OR and get standard immediate pre-op skin prep?

If you DO bathe pre-operatively (any surgery) - what do you use? Thanks! This is for an EBP / research project I am working on.

[labordude, BSN, RN]

I've never worked in any NICU that bathes babies daily, nor are daily baths recommended for infants. I have worked in several surgical NICUs and none of them had specified protocols for pre-operative bathing and many of the agents that would be used for skin prep are not approved for neonates of all gestational ages.

[umcRN, BSN, RN]

I worked NICU and now work cardiac icu. In the NICU we bathed babies 3x a week, nothing special night pre-op (cardiacs do not go to our nicu though), soap and water baths on bath night. In the cicu we bathe every night but use those icky bathwipes and "chlorohexadine" bath wipes ( I cant remember their actual name at the moment). On pre-op nights they get a chlorahexadine bath at 10pm and 4am. 99% of our infants are inpatient prior to surgery whether in the CICU or heart and kidney unit (our step down). Most of our babies, except the very premature, never go to the NICU

[TiffyRN, BSN, PhD]

In general, the infants in our NICU are bathed every 3 days. As they get older, they might go to every other day baths (per the bedside nurses' general consensus). Some very chronic fussy older babies will get nightly baths as part of a bedtime routine to help them sleep.

In general infants are not bathed before surgery unless they are due to get a bath. Some nurses will think ahead about how the infant may not feel that great right after surgery and give the infant a bath the night before. A few times (but not consistently) an infant will be ordered a pre-op chlorhexidine bath. Care must be used with chlorhexidine use in pre-term infants.

The unit where I work is a level III with all our surgeries done next door across a walkway at a children's hospital. We take most standard surgeries though we transfers out all "heart" babies so the only heart surgeries we keep would be the PDA ligations.