Date Approved
4-27-2026
Graduate Degree Type
Dissertation
Degree Name
Nursing (D.N.P.)
Degree Program
College of Nursing
First Advisor
Amy Rohn, DNP, MSN, RN
Academic Year
2025/2026
Abstract
Background: Neonatal bathing practices in neonatal intensive care units (NICUs) often vary despite evidence supporting delayed bathing, standardized techniques, and infection prevention strategies. This variation may increase the risk of hypothermia, skin injury, and central line–associated bloodstream infections (CLABSIs), particularly among premature and medically fragile infants.
Local Problem: A Level IV NICU identified inconsistencies in neonatal bathing practices, variability in documentation, and the absence of standardized guidelines to support evidence-based care.
Methods: This quality improvement Doctor of Nursing Practice (DNP) project used the Johns Hopkins Evidence-Based Practice (JHEBP) model to guide the development and implementation of neonatal bathing guidelines. Key interventions included creation of standardized practice recommendations, targeted nursing education, leadership rounding, and strategies to reinforce practice change. A pre-implementation registered nurse survey was conducted to evaluate baseline knowledge, practice variation, and educational needs.
Interventions: Implementation strategies included self-paced educational modules, bedside coaching, leadership rounding, and just-in-time education. Evidence-based recommendations addressing bathing timing, frequency, technique, and infection prevention were introduced to promote practice consistency.
Results: Evaluation focused on feasibility outcomes, including staff engagement, education completion, and identification of practice variation. Clinical outcome measures, such as infection rates, were not evaluated due to project timeline limitations.
Conclusions: Standardized neonatal bathing guidelines can be successfully implemented in a complex NICU setting. Structured implementation strategies, staff engagement, and evidence-based standardization are essential to promoting consistent nursing practice. Future efforts should evaluate sustainability, adherence, and clinical outcomes.
ScholarWorks Citation
Cole, Holly E., "Implementation of Evidence-Based Neonatal Bathing Guidelines in a Level IV NICU: A Quality Improvement Project" (2026). Doctoral Dissertations. 78.
https://scholarworks.gvsu.edu/dissertations/78
