Swaddled Immersion Bathing for Healthy Full-Term and Late-Preterm Newborns

Abstract

An academic medical center’s implementation of an evidence-based practice change to provide swaddled immersion bathing to healthy full-term and late-preterm newborns in the well-baby nursery. The purpose of this project was to align with the Association of Women’s Health, Obstetric and Neonatal Nurses’ (AWHONN’s) evidence-based clinical practice guideline, Neonatal Skin Care, in the use of swaddled immersion tub bathing. The goal is for newborns and caregivers to experience the benefits when switching from sponge to swaddled immersion bathing while overcoming challenges and building into daily practice on the mother–baby unit. Swaddled immersion bathing is recommended by AWHONN as a safe and well-tolerated mode of bathing compared with sponge bathing. Term- and late-preterm neonates who are bathed in a tub experience significantly less variability in body temperature and show reduction in crying and inducement of a calm, quiet state compared with newborns who receive a sponge bath. Comment cards were used to collect baseline data on sponge bathing within the following areas: temperature, perceived newborn stress–crying, and parental involvement. After education of staff and implementation, chart audits and interviews of staff were used to collect data on swaddled immersion bathing. Collection of data via our comment cards and chart review of 61 total baths demonstrated a –0.8℉ average temperature change after a sponge bath versus only a –0.1℉ average temperature change after a swaddled immersion bath. The staff interviewed verbalized a decrease in total crying and perceived newborn stress during the swaddled immersion baths versus the sponge baths, as well as an increase in parental involvement during the bath. Swaddled immersion bathing is a safe and pleasurable alternative to sponge bathing in healthy full-term and late-preterm newborns, with many positive benefits for parents and their newborn: decreased stress and crying, more stable heart rate and temperature, and increased parent satisfaction and involvement.