Protecting Perineal Skin Integrity as a Vital Infectious Barrier in Critically Ill Neonates

Skin integrity is a vital infection barrier in critically ill neonates. Premature infants have increased caloric needs and require high density feedings. This results in loose stools. Premature infants have an underdeveloped stratum corneum (the protective outer layer of skin). As a result, perineal skin breakdown or diaper rash is a common problem in the NICU1. Open perineal sores also cause neonatal irritability and parental emotional distress. Despite all these, we lack standardization in skin assessment, documentation, prevention and treatment of diaper rash. Aim Statement: Decrease the incidence of diaper rash among our NICU neonates from 20% to 6% within 12 months.