Journal of nursing care quality
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An extremely low birthweight (ELBW) protocol was developed at this regional neonatal intensive care unit. The focus was the standardization of care related to the implementation/maintenance of a humidified environment and attention to prevention of skin excoriation in the extremely low birthweight infant (< 1000 g). Steps toward successful implementation of the standardized approach required an interdisciplinary commitment, literature review of current practice methodologies, a definition of nursing and medical approach to these infants in the first days of life, and an evaluation of the practice change focusing on patient outcomes. A comparative review was completed that evaluated the change in patient outcomes of the extremely low birthweight infants relative to fluid and electrolyte status in the first five days of life after implementation of the protocol as compared to prior to implementation of the protocol.