looking for bath protocols

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I was just wondering what everyone's doing as far as bathing their neonates. We are a level 3 with no current bathing protocol and unfortunately it has been known for some of our kids to not be bathed in 2wks which is totally disgusting. Personally I change linen every night that i work and make sure that my kids have had a good scrubby bath at least that week. I feel that if a bath is going to send them to heaven then they are on their way anyway and at least they will go clean. just wondered if you had any written policy or anything.

Specializes in NICU, Infection Control.

Don't use soap--it's too alkali, and as someone already mentioned, it destroys the skins natural "acid mantle", which makes them MORE vulnerable to infection.

Watch how each baby tolerates the bath--if he's totally knocked out after, needs more O2, has As & Bs, too tuckered out to eat, it's too much for him. A bad mec baby who desats when someone talks next to his bed is not a good prospect for bathing, no matter how encrusted he is.

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I'm in a level II NICU and we do baths on night shift on Tue/Fri. We use heating lamps on our little guys and use johnson/johnson soap. Some of the older kids we use lavender soap. They get a good night's sleep and they smell good! The bigger kids get baths more often if needed, but everyone gets bathed twice a week is stable. The feeder growers who use all their energy screaming through baths usually get bathed on ng feeding times is possible.

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Specializes in NICU, PICU, educator.

Little micros....they only get weighed once a week, so they get linen changes only if needed and we only wash them with sterile water and a tiny bit of soap in the cracks and crevices. They aren't out running any marathons and most of us are very careful to keep linens clean. They don't need to be bothered and a spot on the bed can be covered with something else.

Big sick kids....we don't touch them. The attending will actually write orders to specify NO BATH NO LINEN CHANGE UNLESS BED IS WET. A sick kid does not need the stress of a bath, especially if it is going to make them flip their gases. We had a nurse bath a sicker kid once and the kid flipped and was so stressed we couldn't bring him around and he ended up going for ECMO...a hard lesson learned at a baby's expense. When we do have to change linens, we get an order for extra sedation for that time so that they are pretty oblivious to what we are doing. IMHO, it isn't worth it to stress the kid to make him/her look pretty. It isn't that people are scared, it is just kind of common sense.

The big chronics get tubbed...whew, nothing like that rotten butt, stinky feet and formula smell :uhoh21: We use lavender soap for them and it really does kind of put them in a good mood. A lot of the time, moms will bring their own bathing stuff for the chronics, which is fine.

Nursery has a protocol that they have to be at least 6 hours old, with a temp greater than 36.5 for 3 temps. Then they bake them under the warmer after the bath :lol2:

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Big sick kids....we don't touch them. The attending will actually write orders to specify NO BATH NO LINEN CHANGE UNLESS BED IS WET. A sick kid does not need the stress of a bath, especially if it is going to make them flip their gases. We had a nurse bath a sicker kid once and the kid flipped and was so stressed we couldn't bring him around and he ended up going for ECMO...a hard lesson learned at a baby's expense. When we do have to change linens, we get an order for extra sedation for that time so that they are pretty oblivious to what we are doing. IMHO, it isn't worth it to stress the kid to make him/her look pretty. It isn't that people are scared, it is just kind of common sense.

We dont tuch our Mec asp kids or PPHN either. Like one of our docs sais: "it is better to be a here dirty than clean in heaven". They usually get better in a few days anyway so we just wait.

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Specializes in NICU.
We dont tuch our Mec asp kids or PPHN either. Like one of our docs sais: "it is better to be a here dirty than clean in heaven". They usually get better in a few days anyway so we just wait.

We don't bathe those kids either. I love the quote from your doc!

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We dont tuch our Mec asp kids or PPHN either. Like one of our docs sais: "it is better to be a here dirty than clean in heaven". They usually get better in a few days anyway so we just wait.

:lol2: You know, when I did adults we had a thing about bathing pts with "that look". We'd say," Don't bath so and so. I think he's looking to leave us." becuase as soon as we'd bath a pt like that, they'd code! :uhoh21:

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Specializes in NICU.

At the Level III where I work, we do all of our baths on nights. For babies 1000g, we give baths every 3 nights. Once again, if the kid is too critical to get a bath, it just gets deferred until they are stable enough. Linens get changed every night with weights, and are also changed as needed (after a messy procedure...). For our "chronics", we usually change them to doing baths/weights during the afternoon/early evenings. This way, there is less to do with them at night when they should be sleeping more. As far as soap is concerned, we just use the Johnson and Johnson stuff. Although parents frequently bring in their own stuff from home for us to use.

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Specializes in NICU/Neonatal transport.

We bathe on Tues. and Sat. Overbathing was a very large issue for us and so they're trying to really enforce that. With the older chronics, it's different because they get dirtier. Nights is when we bathe and weigh. :)

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I work in a level III NICU and our policy is that babies get baths every other day, temp must be at least 36.5, newborns get bathed the first time shortly after admission (as stability allows). While I totally get the wisdom of having baths done on certain days (like everyone gets baths Tues and Sat), I like that our kids fall on different days so that most of the time if you're assignment is a three-way, at most only 2 out of the 3 will require baths in a single night (and actually, if all three are due, it isn't a big deal not to bathe one and leave them for the next night-- it's not like we let them mud wrestle). Baths, along with daily weights, are usually done on the night shift, unless the patient is getting ready to go home (then we do it on days so the family can participate) or if the patient is a chronic bigger baby and generally sleeps through most of the night. Chronic big kids that tend to be sweaty/ smelly often get daily baths, per the nurse's/ parent's discretion (for those on tub baths, it is often a soothing part of their routine). Linens are changed every night regardless of bath status. We use Johnson's head to toe body wash, very sparingly with the micropreemies.

That said, if the patient is not stable enough to be bathed, they don't get bathed until they are-- this includes PPHN, CDH babies, Mec Aspirates and any other very sick/ labile baby. Linens for these babies are changed as needed/ tolerated.

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Specializes in Neonatal.

Wow! It's so interesting to read what all of you do in different hospitals!

We wash babies (and change linens) every other day, if the assignement permits it. The baths are assigned for the night shift nurses, along with morning weights and blood tests.

Once the baby is off the vent and IV, we give the parents a bath demo and tell them to wash their kid every second day or so. We use whichever baby soap the parents bring in (they provide their own - I like Aveeno).

We do sponge baths for babies 1800g.

If we're giving a tub bath, we wet the umbilical cord , but make sure to dry it well afterwards. The first bath usualy takes place within the first 8h of life, if the baby's condition permits it and temperature is >36.5.

We do not wash babies on HFV, unless they're realy filthy. Same goes for their sheets.We do not weigh HFV babies :nono:, instead we use a dry weight.

As for our micropreemies, we wash them with sterile water the first couple of times. Sentless soap can be used after the first week of life. These kids usualy get bathed less frequently ( q 3-4 days). However, we weigh our micropreemies every shift (3 times/day) until they are 1 week old.

Of course, linens can get changed more frequently if they're dirty ;)

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I am a littlke late chiming in on this, but we bathe everynight, sometimes only water and only face and groin depending on what the baby needs. Linen are changed every night, and tif the kid is PPHN or anything else that will try and die if you touch them we use our nursing judgement as to wiping their face or even doing nothing at all. How disgusting to not bathe a baby for 2 weeks!! OR change the linen!!! We dont have a protocol for it, nurses just want their patients to be in a clean bed with a clean face (you know how vent kids get yucky mouths.)

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