Topical Use of Human Milk in the Neonatal Intensive Care Unit: An Integrative Review.

BACKGROUND: Research has shown that the bioactive components in human milk could demonstrate efficacy when applied topically. One common neonatal skin issue is diaper dermatitis (DD). DD treatment and prevention guidelines often lack the inclusion of topical human milk as a viable option. PURPOSE: To analyze the safety and efficacy of topical human milk application as a means to support future research of human milk as a topical treatment for DD. DATA SOURCES: Google Scholar, CINAHL, PubMed, and Cochrane. STUDY SELECTION: The search was limited to articles published between 2011 and 2023 in the English language. Disqualifying characteristics included nonhuman subjects, literature reviews, inability to obtain articles, and non-peer-reviewed articles. DATA EXTRACTION: For Google Scholar, the search terms "human milk OR breast milk" and "topical" were used. For CINAHL, PubMed, and Cochrane, the search terms "human milk OR chest milk OR breast milk OR donor milk" and "topical" were used. Quantitative significance was defined by a P value of less than .05. RESULTS: The search yielded 20 articles. The results of the review demonstrate that topical human milk application is a safe and effective topical treatment to skin integrity/inflammatory issues such as DD. It also identified that caregivers will likely show positive regard to the treatment, promoting its acceptance. IMPLICATIONS FOR PRACTICE AND RESEARCH: The results provide evidence to support methodologic development for human milk application for the prevention and treatment of DD. Further studies can use the results to develop protocols that investigate the effects of human milk application.

An Adaptation of the Skin Safety Model to Guide Diaper Dermatitis Research in the NICU.

Diaper dermatitis is an ever-present condition among infants. Little is known about the prevalence among infants in the NICU. This article presents an adaptation of the skin safety model (SSM) for the infant in the NICU. The concepts of the model were extracted, defined, and integrated into an adapted SSM model to provide a focus on the infant with diaper dermatitis in the intensive care setting. It is essential to include all factors of the infant's clinical characteristics and hospital experience in the modeling to accurately predict risk of skin vulnerability in this infant population.

A Review of the NANN Research Summit Experience: Continuing to Promote a Platform for Research and Clinical Inquiry.

BACKGROUND: The NANN Research Summit has been providing a platform for neonatal scholarship and clinical inquiry for 15 years. As the discipline of nursing and nursing research continue to evolve, it is important to gain perspective on current trends and needs for areas of strength and growth. PURPOSE: To evaluate participant outcomes of the NANN Research Summit and determine opportunities for improvement. METHODS: A 9-question survey was sent to 90 past participants for the Research Summit years 2015-2019. RESULTS: Thirty-seven (41%) participants from 2015 to 2019 responded. Of those responding, 75% continued to pursue their presentation topic; 95% felt empowered to continue their research based on their Summit experience; 84% felt more comfortable presenting their research findings after attending; 84% felt confident in publishing research after attending the Summit, with 43% reporting publications. These accomplished results would not have been possible without Mead Johnson's support. In addition, 57% did not publish the work presented and 65% lacked continued mentorship. IMPLICATIONS FOR PRACTICE: A redesigned Summit is presented to address the priorities for growth and alignment with continued emphasis on collegiality among neonatal nurse scholars. The redesigned Summit will promote continued clinical inquiry as a result of intentional focus on mentorship and development of scholarship. IMPLICATIONS FOR RESEARCH: The data collected from this initial survey will continue to serve as the basis for future data collection. Continued evaluation of strengths and areas for growth including the number of publications and mentorship experience can lead to expansion of research for the Summit facilitators and participants.

An Integrative Review of Clinical Characteristics of Infants With Diaper Dermatitis.

BACKGROUND: Diaper dermatitis (DD) severity is demonstrated by the degree of erythema and skin breakdown. Many studies describe diaper dermatitis, but lack a full description of clinical characteristic (CC) involvement. PURPOSE: The purpose of this literature review is to explore the descriptions of CC of infants with DD provided within infant DD literature. SEARCH STRATEGY: PubMed and Web of Science were searched using the keywords: diaper dermatitis, diaper rash, infant, and neonate. The inclusion criteria for this project are as follows: published after 1990, English language, include skin assessment or evaluation, and infant/children < two years of age. Review and opinion articles were excluded. RESULTS: A total of 454 studies were retrieved, 27 remained after review for duplicates and relevance. The CC described most often were: type of feeds, stool frequency, history of DD, use of antibiotics, and delivery mode. SYNTHESIS OF EVIDENCE: The studies reported inconsistent CC and a lack of correlation between these characteristics and the condition of diapered skin. Many studies focused solely on the efficacy of interventions lacking description of possible relationships between DD and CC. IMPLICATIONS FOR PRACTICE: Skin condition outcome variables can be improved with the acknowledgment of the impact CC have on the development of DD. The combination of assessment measures and CC may ultimately demonstrate more merit or rigor for describing DD severity and skin condition. IMPLICATIONS FOR RESEARCH: Future research should expand this exploration to include environmental or contributing factors to continue to identify additional risk factors for DD.