title: Beginning at the bottom: evidence-based care of diaper dermatitis.
abstract: Diaper dermatitis (DD), an acute inflammatory reaction of skin in the perineal area, is an extremely common pediatric condition. Nurses' practice of preventing and treating DD is inconsistent and often not evidence-based. In addition, a 2008 Skin Injury Prevalence Study at our hospital revealed that 24% of inpatients had DD. The authors developed a project to determine a consistent and evidence-based approach to DD prevention and treatment including the availability of products. A complete literature review was conducted in addition to benchmarking with other pediatric hospitals, consultation with topic experts, and evaluation of current nursing practice prior to revising the existing perineal skin care nursing standard. The evidence supports frequent diaper changes, use of super absorbent diapers, and protection of perineal skin with a product containing petrolatum and/or zinc oxide. As supported by the literature, we revised the standard to include improvements in practice as well as product updates for prevention and treatment. Hospital-wide implementation of the revised standard included training "Skin Care Champions" to educate staff and support practice improvements. Ongoing education and monitoring by the Skin Care Champions is necessary to further improve the prevention and treatment of DD for our patients.
authors.affiliation: Newborn/Infant Intensive Care Unit, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. heimalll@email.chop.edu
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Heimall
authors.forename: Beth
authors.initials: B
authors.lastname: Storey
authors.forename: Judith J
authors.initials: JJ
authors.lastname: Stellar
authors.forename: Katherine Finn
authors.initials: KF
authors.lastname: Davis
mesh_terms: D003963:Diaper Rash / Q000451:nursing* / Q000517:prevention & control*; D055318:Evidence-Based Nursing; D006801:Humans; D009732:Nursing Care / Q000592:standards*; D010577:Petrolatum / Q000627:therapeutic use; D017592:Skin Care / Q000451:nursing* / Q000592:standards*; D014481:United States; D015034:Zinc Oxide / Q000627:therapeutic use
chemical_list: D010577:Petrolatum; D015034:Zinc Oxide