Date of Award

Spring 3-11-2018

Degree Type

Final Project

Degree Name

DNP Doctor of Nursing Practice




Mary Ellen Roberts, D.N.P.

Committee Member

Patricia Ricci-Allegra, D.N.P.

Committee Member

Donna Bowman, D.N.P.



Background and Objective: Until 2010 newborns at most community-based hospitals were subjected to their initial bath within two hours of birth. However, this practice has recently changed due to the evidence-based recommendations that demonstrate improved outcomes for neonates when the first bath is delayed for 12-24 hours after birth. Upon delivery, infants are placed skin-to-skin with their parents to promote thermoregulation, breast feeding and bonding. The purpose of this project was to implement a program that delayed infant bathing until the infant was approximately 24 hours old. Rates of neonatal hypoglycemia, neonatal hypothermia, exclusive in-hospital breastfeeding and formula supplementation rates were explored after implementation of the delayed infant bath. The population targeted in the project included well infants at a local community hospital. The primary objectives were to discuss the traditional versus more recent evidence-based nursing practices for newborns, review the implementation plan for the delayed sponge bathing program, and review newborn clinical outcomes as a result of implementing this evidence-based practice.

Significance: This project is significant to the improvement of the overall health of neonates. This can be achieved by providing education to hospital staff aimed at improving nursing knowledge and practice, which will, in turn, promote improved neonatal outcomes.

Methods: Orlando’s nursing theory provided the theoretical framework for the implementation of this program. The methodology was comprised of the following: needs assessment, presentation of the program to the stakeholders to obtain approval and support, staff and parent education, and the implementation of the delayed infant bathing program including benchmarking clinical outcomes data.

Project Outcomes: Before the implementation of this evidence-based practice, clinically stable infants were bathed within two hours of life. The infants and parents participating in the program benefited from the improved nursing care that was a direct result of the education and knowledge gained during this program implementation. In-hospital breastfeeding rates improved by 10 percent and formula supplementation decreased by 10 percent. It was also noted that delayed promote overall infant health.

Clinical Relevance: The implementation of a delayed infant bathing program has substantial health benefits to newborns and families, including increased bonding, improved breastfeeding rates, reduced incidence of hypoglycemia and demonstrated parent participation in their infant’s care. Nurses, in turn, are driving evidence-based care which standardizes healthcare practices and reduces unsubstantiated variations in care.


Final revisions.