Judy Wright Lott

Neonatal skin care: the scientific basis for practice.

Objective: To review the literature addressing the care of neonatal skin. Data Sources: Computerized searches in MEDLINE and CINAHL, as well as references cited in articles reviewed. Key concepts in the searches included neonatal skin differences; neonatal skin and care practices for skin integrity; neonatal skin and toxicity; permeability; and contact irritant sensitization. Study Selection: Articles and comprehensive works relevant to key concepts and published after 1963, with an emphasis on new findings from 1993 to 1999. One hundred two citations were identified as useful to this review. Data Extraction: Data were extracted and organized under the following headings: anatomy and physiology of the skin; physiologic and anatomic differences in neonatal skin; nutritional deficiencies; skin care practices; and care of skin breakdown. Data Synthesis: Newborns’ skin is at risk for disruption of normal barrier function because of trauma. In light of available evidence about differences in neonatal skin development, clinical practice guidelines are suggested for baths, lubrication, antimicrobial skin disinfection, and adhesive removal. In addition, basic care practices are suggested for maintaining skin integrity, reducing exposure to potentially toxic substances, and promoting skin health beyond the neonatal period. Preventive care recommendations are made for reducing trauma, protecting the skin’s immature barrier function, and promoting skin integrity. Conclusions: This review generated evidence with which to create a new and comprehensive practice guideline for clinicians. Evaluation of the guideline is under way at 58 U.S. sites.

Coping with transition: Neonatal nurse practitioner education for the 21st century

As neonatal intensive care nurses face downsizing and/or cross-training, new opportunities are emerging for advanced practice nurses in follow-up care of neonatal intensive care unit graduates, case management, quality improvement, and community hospital care. This article identifies current issues in neonatal nurse practitioner (NNP) education as the model has shifted from hospital-based, certificate programs to graduate degree programs offered by colleges/universities of nursing. Opportunities for increasing NNP role flexibility and recommendations for bridging the transition to a 21st century education model for neonatal advanced practice nurses are also discussed. Despite the turmoil of change and uncertainty, the future for neonatal advanced practice nurses is positive. Successful nurses will master the skills of adaptability, flexibility, self-directed learning, leadership, and the provision of relationship centered care. Neonatal nursing educators must constantly monitor clinical practice and re-evaluate the curriculum to ensure the necessary knowledge and skills for successful practice can be achieved from the educational program. It is critical that faculty are cognizant of emerging trends and changing roles in the practice area. Additional learning opportunities may be required for graduates to successfully move into the next century.

Neonatal Skin: The Ideal Nursing Interface

Human skin holds much fascination for the average person. It is the first thing that is noticed about a person. From a neonatal perspective it is a dynamic interface with the surrounding environment and provides the surface for our nursing interventions. This article will discuss this dynamic interface and why it provides a good scientific basis for neonatal nursing care.

Role stress and strain among nondoctorally prepared undergraduate faculty in a school of nursing with a doctoral program.

Initiation of a doctoral program within existing schools of nursing causes significant change in organizational structure and function. The role expectations of the current faculty change as well. The purpose of the qualitative study was to identify if role stress and strain are present in nondoctorally prepared undergraduate nursing faculty in a southern university school of nursing with a doctoral program. The design was a qualitative, open-ended interview. The primary research question was: Does the initiation of a doctoral program in a school of nursing impose role stress and strain on nondoctorally prepared faculty members? Academic educators will find our results interesting because faculty report that role stress and strain affect both their teaching and decisions to remain in academia. Use of these findings may contribute toward improved role relationships, better role performance, greater job satisfaction, and decreased job turnover.