|
1
|
Jani P, Mishra U, Buchmayer J, Maheshwari R, D'Çruz D, Walker K, Gözen D, Lowe K, Wright A, Marceau J, Culcer M, Priyadarshi A, Kirby A, Moore JE, Oei JL, Shah V, Vaidya U, Khashana A, Godambe S, Cheah FC, Zhou WH, Hu XJ, Satardien M. Global variation in skin injures and skincare practices in extremely preterm infants. World J Pediatr 2023; 19:139-157. [PMID: 36372868 PMCID: PMC9660114 DOI: 10.1007/s12519-022-00625-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/19/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Globally, are skincare practices and skin injuries in extremely preterm infants comparable? This study describes skin injuries, variation in skincare practices and investigates any association between them. METHODS A web-based survey was conducted between February 2019 and August 2021. Quantifying skin injuries and describing skincare practices in extremely preterm infants were the main outcomes. The association between skin injuries and skincare practices was established using binary multivariable logistic regression adjusted for regions. RESULTS Responses from 848 neonatal intensive care units, representing all geographic regions and income status groups were received. Diaper dermatitis (331/840, 39%) and medical adhesive-related skin injuries (319/838, 38%) were the most common injuries. Following a local skincare guideline reduced skin injuries [medical adhesive-related injuries: adjusted odds ratios (aOR) = 0.63, 95% confidence interval (CI) = 0.45-0.88; perineal injuries: aOR = 0.66, 95% CI = 0.45-0.96; local skin infections: OR = 0.41, 95% CI = 0.26-0.65; chemical burns: OR = 0.46, 95% CI = 0.26-0.83; thermal burns: OR = 0.51, 95% CI = 0.27-0.96]. Performing skin assessments at least every four hours reduced skin injuries (abrasion: aOR = 0.48, 95% CI = 0.33-0.67; pressure: aOR = 0.51, 95% CI = 0.34-0.78; diaper dermatitis: aOR = 0.71, 95% CI = 0.51-0.99; perineal: aOR = 0.52, 95% CI = 0.36-0.75). Regional and resource settings-based variations in skin injuries and skincare practices were observed. CONCLUSIONS Skin injuries were common in extremely preterm infants. Consistency in practice and improved surveillance appears to reduce the occurrence of these injuries. Better evidence regarding optimal practices is needed to reduce skin injuries and minimize practice variations.
Collapse
Affiliation(s)
- Pranav Jani
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
- Department of Neonatology, Westmead Hospital, Westmead, NSW, 2145, Australia.
| | - Umesh Mishra
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Neonatology, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - Julia Buchmayer
- Comprehensive Center for Pediatrics, Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria
| | - Rajesh Maheshwari
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Neonatology, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - Daphne D'Çruz
- Department of Neonatology, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - Karen Walker
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Newborn Care, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- Council of International Neonatal Nurses, Boston, MA, USA
- The George Institute for Global Health, Sydney, NSW, Australia
- Sydney Institute for Women, Children and Their Families, Sydney, NSW, Australia
| | - Duygu Gözen
- Pediatric Nursing Department, Florence Nightingale Faculty of Nursing, İstanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Krista Lowe
- Department of Neonatology, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - Audrey Wright
- Department of Neonatology, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - James Marceau
- Department of Neonatology, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - Mihaela Culcer
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Neonatology, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - Archana Priyadarshi
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Neonatology, Westmead Hospital, Westmead, NSW, 2145, Australia
| | - Adrienne Kirby
- The National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - James E Moore
- Connecticut Children's Division of Neonatal-Perinatal Medicine, Connecticut Children's Medical Center, Hartford, CT, USA
- UCONN School of Medicine, Farmington, CT, USA
| | - Ju Lee Oei
- The Royal Hospital for Women, Randwick, NSW, Australia
- School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia
| | - Vibhuti Shah
- Department of Paediatrics and Institute of Health Policy, Management and Evaluation, Mount Sinai Hospital, Toronto, Canada
| | - Umesh Vaidya
- Department of Pediatrics, King Edward Memorial Hospital, Pune, India
| | | | - Sunit Godambe
- Divisional Director for Clinical Governance, Women's, Children's and Clinical Support, Imperial College Healthcare NHS Trust, London, UK
| | - Fook Choe Cheah
- Department of Pediatrics, Faculty of Medicine, Universiti Kebangsaan, Bangi, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | - Wen-Hao Zhou
- Department of Neonatology and Vice President, Children's Hospital of Fudan University, Shanghai, China
| | - Xiao-Jing Hu
- Vice Director of Nursing Department, Children's Hospital of Fudan University, Shanghai, China
| | - Muneerah Satardien
- Department of Paediatrics and Child Health, Tygerberg Hospital, Cape Town, South Africa
- University of Stellenbosch, Cape Town, South Africa
| |
Collapse
|