Fresh Perspectives on Hospital-Acquired Neonatal Skin Injury Period Prevalence From a Multicenter Study

August, Deanne; Kandasamy, Yoga; Ray, Robin; Lindsay, Daniel; New, Karen

doi:10.1097/jpn.0000000000000513

Cited by 19 publications

(11 citation statements)

References 36 publications

(81 reference statements)

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“…Mechanical force skin injuries have been identified in the literature as a neonatal complication since the 1980s 1,2 . Neonates are particularly vulnerable to skin injuries related to hospitalised care, with a variety of severities identified in previous studies 3 . Some of these injuries have lasting impacts such as scarring which affects movement and self-esteem for the individual affected 4,5 .…”

Section: Introductionmentioning

confidence: 97%

“…However, while neonates sustain skin injuries from a number of mechanical forces similar to adults, the maturity of neonatal skin puts the application of adult injury scales into question 1,2,7 . A mechanical skin injury is defined as a distortion or injury of the integrity of the skin and/or underlying integumentary structures by external motion 3,6 . Common forces associated with skin injury for the neonatal population include pressure (a source exerting force on the skin), friction (resistance created by surfaces moving between skin and surface), shearing (still outer layers with inner layers moving transversely), tear (blunt force resulting in separation of skin layers) 8,9 and stripping (when adhesive is more strongly bonded to the skin than the intradermal bonds, this is known as medical adhesive-related skin injury [MARSI]) 10 .…”

Section: Introductionmentioning

confidence: 99%

“…Currently, there is no neonatal-specific standard of injury assessment including severity 3,5 . Premature skin is particularly at risk for injury related to weak cohesion in the dermoepidermal junction and is oedematous, making it less stable and more prone to skin layer separation 13 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Neonatal skin injury scales: a scoping review with narrative synthesis protocol

Hall¹,

August²,

Coyer³

et al. 2022

WPR

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Background Mechanical skin injuries have been a neonatal complication since the 1980s but a number of factors affect their assessment, particularly the assessment of injury severity. Whilst there is a single severity and classification system used to assess adult pressure injuries within Australia, there are no neonatal-specific standards for injury assessment. Unfortunately, neonates sustain skin injuries frequently and, whilst there are some similarities to adult injuries, the maturity of neonatal skin puts the application of adult injury scales into question. In addition, several severity systems are currently utilised, thus outcomes for skin injury prevention or management strategies are difficult to compare.Aims This review will investigate severity scales used for neonatal skin injury. Secondly, this review will determine the (i) characteristics of severity scales such as ordinal or categorical groupings and (ii) assessment of scale validation for population.Methods This scoping review will utilise the PRISMA-ScR framework and the 2015 Joanna Briggs Institute methodology. The electronic medical databases chosen are PubMed, CINAHL, COCHRANE Central and Scopus. Publications from within the last 20 years will be included to ensure the scales and the neonatal population reflect the timepoint when neonatal skin care became a safety and quality outcome as recognised by international seminal works. Ethics and disseminationAs the data (i.e. journal articles) used is publicly available, ethical approval was not required for this scoping review. A peer-reviewed journal and conference presentation will then be used to disseminate findings.

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Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Neonatal skin injury scales: a scoping review with narrative synthesis protocol

Hall¹,

August²,

Coyer³

et al. 2022

WPR

View full text Add to dashboard Cite

show abstract

“…A single adhesive removal has been shown to strip 70–90% of a baby’s epidermis (though multiple adhesive replacements can cause deeper injury), as the adherence of tape-to-skin is often stronger than the adherence of skin layers to each other [ 8 ]. Skin injuries are common in the NICU and the majority are unreported, of those reported most are related to the devices used by clinicians to provide patient care [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Securing peripheral intravenous catheters in babies without applying adhesive dressings to the skin: a proof-of-concept study

et al. 2022

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Background Most babies admitted to a Neonatal Intensive Care Unit (NICU) require a peripheral intravenous catheter (PIVC). PIVCs are secured using splints and adhesive dressings applied to the skin. Removing the dressings causes skin injury, pain, and risks infection. We designed the Pēpi Splint, which supports PIVCs without the application of adhesive dressings to the skin. We sought to determine the effectiveness and acceptability of the Pēpi Splint using a proof-of-concept design. Methods Eligible babies were > 1000 g and > 30 weeks’ corrected gestation admitted to Wellington Regional NICU and who required a PIVC. All babies received the same care as those not in the study, with the addition of the Pēpi Splint. Primary outcomes were the proportion of babies in which the Pēpi Splint secured the PIVC for the required time and proportion of babies who experience an adverse event. Secondary outcomes were the acceptability of the Pēpi Splint as reported by the parents. Results Thirty-eight babies, median (range) birth weight 2625 g (396—4970) and gestation 37wk (22—41). When the Pēpi was applied the postnatal weight was 2969 g (1145 – 4970) and gestation 37wk (29 – 41). The Pēpi Splint held the PIVC secure for 34/38 babies (89%), for a duration of 37 h (6 to 97). There were no adverse events. Of the four babies reported to have unsecure PIVCs, two were due to the securement two were displaced during feeding. Fifty-eight parents responded to a questionnaire (32 mothers, 26 fathers). Of these parents 52 (90%) would participate again and 52 (90%) would recommend participating to others. Overall, clinicians reported the Pēpi Splint was easy to use 33/38 (87%). Conclusion The Pēpi Splint safely secures PIVCs without adhesive dressings being applied to the skin and is acceptable to both parents and clinicians. Our findings provide support for a larger multicentred randomised controlled trial. Trial registration Registered with the Australian and New Zealand Clinical Trials Registry Reference ACTRN12620001335987.

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“…The risk of neonatal skin injuries in NICU is as high as 43.1 percent [7]. Several large studies performed on newborn infants reported skin breakdown, pressure injuries, and skin-stripping because of the fixation, pressure, and removal of medical adhesives [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

An E-Textile Respiration Sensing System for NICU Monitoring: Design and Validation

Cay

Ravichandran

Saikia

et al. 2021

J Sign Process Syst

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The world is witnessing a rising number of preterm infants who are at significant risk of medical conditions. These infants require continuous care in Neonatal Intensive Care Units (NICU). Medical parameters are continuously monitored in premature infants in the NICU using a set of wired, sticky electrodes attached to the body. Medical adhesives used on the electrodes can be harmful to the baby, causing skin injuries, discomfort, and irritation. In addition, respiration rate (RR) monitoring in the NICU faces challenges of accuracy and clinical quality because RR is extracted from electrocardiogram (ECG). This research paper presents a design and validation of a smart textile pressure sensor system that addresses the existing challenges of medical monitoring in NICU. We designed two e-textile, piezoresistive pressure sensors made of Velostat for noninvasive RR monitoring; one was hand-stitched on a mattress topper material, and the other was embroidered on a denim fabric using an industrial embroidery machine. We developed a data acquisition system for validation experiments conducted on a high-fidelity, programmable NICU baby mannequin. We designed a signal processing pipeline to convert raw time-series signals into parameters including RR, rise and fall time, and comparison metrics. The results of the experiments showed that the relative accuracies of hand-stitched sensors were 98.68 (top sensor) and 98.07 (bottom sensor), while the accuracies of embroidered sensors were 99.37 (left sensor) and 99.39 (right sensor) for the 60 BrPM test case. The presented prototype system shows promising results and demands more research on textile design, human factors, and human experimentation.

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Fresh Perspectives on Hospital-Acquired Neonatal Skin Injury Period Prevalence From a Multicenter Study

Abstract: The objective of this study was to explore neonatal skin injury period prevalence, classification, and risk factors. Skin injury period prevalence over 9 months and χ 2 , Mann-

Cited by 19 publications

References 36 publications

Neonatal skin injury scales: a scoping review with narrative synthesis protocol

Neonatal skin injury scales: a scoping review with narrative synthesis protocol

Securing peripheral intravenous catheters in babies without applying adhesive dressings to the skin: a proof-of-concept study

An E-Textile Respiration Sensing System for NICU Monitoring: Design and Validation

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