the case of the missing baby powder
Kristie Newton RN, BSN
April 2007
Case Scenario and Clinical Issue
For as long as I have been a nurse, I have used baby powder when bathing my patients. I have used it to freshen up patients, rub their backs, and sometimes as an air freshener. So you can imagine my confusion when baby powder disappeared from the supply room. At first, I figured we were just out of it, since other items were on back order. However, when I noticed they had eliminated the bin used for baby powder, I began asking questions. All I was told was we were not using baby powder anymore, “it causes infections.” I could not believe this explanation. What does baby powder have to do with infections? After all, it is safe for babies, why not patients?
clinical issue
The clinical issue I wanted to address was why, after 20 years of nursing, was this the first time I had ever heard about baby powder being bad for patients?
PICO Question
In caring for hospitalized patients, does using baby powder compared to not using baby powder increase the rate of infection?
evidence journey
I had the opportunity to speak with the Clinical Nurse Specialist (CNS) of the ICU about my question. She was able to show me study after study linking baby powder to topically yeast infections and fungal infections in immunocompromised patients, and how it was detrimental when talc was inhaled for respiratory patients, i.e. asthmatics. I was speechless. Why had I never heard of this before? Apparently, these studies had been available for years and our hospital was way behind in changing this practice.
Had I been living in a bubble? Why had I never known this before? Because of NUR 500, I knew how to search databases to see the evidence for myself. I even asked the nurses who had come from other hospitals other than Arizona. I was amazed to see the evidence and find out that other hospitals stopped using baby powder years ago.
implementation of evidence
After seeing the evidence for myself, I was able to better answer other nurses when they inquired about why we did not stock baby powder anymore. In addition, I was able to educated patients families when they brought baby powder in for their family member. Once they understood, they agreed to take the powder home. When we receive patients from another facility, I make sure there is no baby powder included with their belongings.
outcome
According to the CNS of ICU, hospital acquired infections have decreased since the change in policy. The Infection Control nurse has been collecting data and monitoring the infection rates.
reflection
My graduate education was my first experience in understanding what using evidenced based practice meant. I had heard the CNS mention it during grand rounds, but I never knew about how to search for the evidence. I feel I now have the knowledge and skills to find my own evidence that may someday change the way I practice as a NP. I feel including EBP in my nursing career can only enhance how I care for my patients now and in the future when I become a NP. EBP gives me the tools to question why we do some of the things that “have always been done that way.” As a result of EBP, I will know I am delivering the best care supported by the best evidence.
