In collaboration with the approved course preceptor, students will identify a specific evidence-based topic for the capstone project change proposal. Students should consider the clinical environment in which they are currently employed or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a leadership or quality improvement initiative, or an unmet educational need specific to a patient population or community. The student may also choose to work with an interprofessional collaborative team.
Students should select a topic that aligns with their area of interest as well as the clinical practice setting in which practice hours are completed.
Write a 500-750 word description of your proposed capstone project topic. Include the following:
The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project will be the focus of the change proposal.
The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed.
A description (providing a high level of detail) regarding the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.
Effect of the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project.
Significance of the topic and its implications for nursing practice.
A proposed solution to the identified project topic with an explanation of how it will affect nursing practice.
You are required to cite a minimum of eight peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice. Plan your time accordingly to complete this assignment.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
P– Population- Newborns
I-Intervention- Delayed Bathing of Healthy Tern Babies
C– comparison- Bathing the child within the first hours of birth.
O– outcome- Promoting Breastfeeding, increasing chances of newborn survival through skin-to-skin contact, preventing dry skin, and preventing hypothermia.
PICO statement: Delayed bathing in healthy term babies of 24 hours compared to bathing them within the first two hours promotes breastfeeding, increases chances of newborn survival, and prevents hypothermia and hypoglycemia.
Newborns are delicate and need a bath after birth so as to prevent infections and maintain their skin condition. A newborn’s skin is soft and delicate and therefore there is a need to prevent it from getting harmed by bacteria (University of Rochester Medical Center, 2021). Even so, there have been recent recommendations from the World Health Organization that recommend that there should be delayed baths in newborn babies (WHO, 2017). Additionally, WHO also recommends that newborns during their first hour of life, should experience skin-to-skin contact with their mothers so as to prevent hypothermia and promote breastfeeding.
Importance of Delayed Bathing
Delayed bathing in healthy-term newborns helps in preventing hypothermia and hypoglycemia (Warren et al., 2020). When newborns get baths right away after birth, they are likely to develop a cold that may lead to hypothermia as they are not yet adapted well to being outside the mother’s body (Mardini et al., 2020). Additionally, they may also develop a drop in their sugar levels which may lead to hypoglycemia. Hypoglycemia and hypothermia in newborns may lead to death or the newborns may develop health complications that may be hard to treat effectively (Preer et al., 2013).
According to WHO, newborns should be in the first hour given the opportunity to be breastfed so as to develop the bond with the mother and also reduce the chances of getting hypoglycemic or hypothermic due to lack of food and warmth (WHO, 2017). When the baby after birth is taken right away to a bath, there is the interruption of the mother-child bond and this may interrupt the success of breastfeeding. According to a study done by Preer et al. (2013), there is a 166% increased success in hospital breastfeeding after they implemented a 12-hour delay in a newborn’s bath as compared to those who were given a bath in the first hours after delivery.
Newborns have a wavy white substance called Vernix. Vernix is seen in newborns and coats the baby in the womb and is seen after delivery (Smith & Shell, 2017). The substance is a natural moisturizer and has anti-bacterial properties preventing the baby’s skin from getting damaged and dry (Jha, 2015). According to the American Academy of Pediatrics (2021), they recommend that vernix should be left on the newborn’s skin for some time so as to prevent it from getting dry and cracking out. This prevents the newborn from getting injuries and especially for the preemies who are prone to injuries more.
Newborns are prone to bacteria and hence need to be given a lot of care. The skin of newborn babies is essentially very soft and delicate and is protected by vernix at birth. However, there is the need to keep the child healthy by bathing them after birth. There have been studies and recommendations given by organizations such as the WHO recommending children to have delayed baths so as to prevent them from getting hypothermic, hypoglycemic, and also promote the bond between the mother and child through breastfeeding in the first hour.
University of Rochester Medical Center. (2021). Bathing and Skin Care for the Newborn – Health Encyclopedia – University of Rochester Medical Center. Rochester.edu. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=P02628
Jha, A. K. (2015). Is There a Preventive Role for Vernix Caseosa?: An Invitro Study. JOURNAL of CLINICAL and DIAGNOSTIC RESEARCH. https://doi.org/10.7860/jcdr/2015/14740.6784
Preer, G., Pisegna, J. M., Cook, J. T., Henri, A.-M., & Philipp, B. L. (2013). Delaying the Bath and In-Hospital Breastfeeding Rates. Breastfeeding Medicine, 8(6), 485–490. https://doi.org/10.1089/bfm.2012.0158
WHO. (2017). WHO RECOMMENDATIONS ON Newborn Health GUIDELINES APPROVED BY THE WHO GUIDELINES REVIEW COMMITTEE. https://cdn.who.int/media/docs/default-source/sexual-health/stillbirth/who-mca-17-07-eng.pdf?sfvrsn=bf769add_2
American Academy of Pediatrics. (2021). Bathing Your Baby. HealthyChildren.org. https://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Bathing-Your-Newborn.aspx#:~:text=While%20most%20institutions%20used%20to,t%20possible%20for%20cultural%20reasons.
Mardini, J., Rahme, C., Matar, O., Abou Khalil, S., Hallit, S., & Fadous Khalife, M.-C. (2020). Newborn’s first bath: any preferred timing? A pilot study from Lebanon. BMC Research Notes, 13(1). https://doi.org/10.1186/s13104-020-05282-0
Warren, S., Midodzi, W. K., Allwood Newhook, L.-A., Murphy, P., & Twells, L. (2020). Effects of Delayed Newborn Bathing on Breastfeeding, Hypothermia, and Hypoglycemia. Journal of Obstetric, Gynecologic & Neonatal Nursing, 49(2), 181–189. https://doi.org/10.1016/j.jogn.2019.12.004
Smith, E., & Shell, T. (2017). ICEA Position Paper Delayed Bathing Background. In ICEA. https://icea.org/wp-content/uploads/2018/02/ICEA-Position-Paper-Delayed-Bathing.pdf