The Effect of Replacement Frequency of Electrodes on Skin in Infant
Condition: Infant, Premature
Study type: Interventional

Summary: 
      In the Pediatric Intensive Care Unit (PICU), each child and infant is monitored to determine
      the status of the underlying disease by constantly monitoring the main variables, to help
      diagnosis and to guide treatment. During the monitoring application, electrodes of
      appropriate size for the patient's age and body surface are attached to the appropriate areas
      of the patient where skin integrity is intact, clean, and dry. It is recommended that these
      electrodes be replaced within 24 hours at most, but there is no evidence of the effect of
      electrode replacement frequency on skin moisture and integrity.

      Based on this reason, this study was conducted experimentally in a randomized controlled
      manner to determine the effect of frequency of monitoring electrode replacement on skin
      moisture and condition of infants hospitalized in the PICU.
    

Detailed description: 
      The study was conducted with 66 participants, with the number of participants being 33 in
      both two groups (Experimental and Control Group).The randomization of the sample was
      determined by entering the total number of cases in line with the Research Randomizer
      program.

      The control group of the study involved infants whose monitoring electrodes were replaced at
      the 24th hour after being monitored and the experimental group involved infants whose
      monitoring electrodes were replaced at the 12th and 24th hour after being monitored.

      Before all participants are monitored, skin cleansing was performed on the right second
      intercostal space (Right 2nd ICA), left second intercostal space (Left 2nd ICA) and the left
      lower side of the sternum at the left midclavicular level in the fifth intercostal space
      (Midclavicular 5th ICA). After that, skin moisture was measured where monitoring will be
      performed and skin condition evaluation of these areas. Then the participants were monitored.

      After these applications, skin moisture and skin condition score evaluations were repeated in
      both groups.

      Skin Condition Score The skin condition score, developed by the Association of Women's
      Health, Obstetric and Neonatal Nurses (AWHONN) and validated by Calisir et al. in 2016, was
      used to determine the skin condition. The scale consists of three items and each item
      includes an evaluation criterion. These are dryness, erythema, and skin integrity
      breakdown/peeling, respectively. Each item of the 3-point Likert scale gets 1 to 3 points.
      The lowest score that can be obtained from the scale is 3, the highest score is 9. A high
      total score indicates that the skin condition of the newborn is poor. Permission was obtained
      for the use of the skin condition score from the Association of Women's Health, Obstetric and
      Neonatal Nurses (AWHONN) and the authors who performed the Turkish validity and reliability.

      Skin Moisture Digital Moisture Monitor For Skin was used to measure skin moisture. This
      moisture measuring device measures with "%". This device developed for precise measurement
      has been preferred because of its ability to show the amount of moisture by the contact
      without damaging the skin, being portable, working with a battery, having a wide measurement
      range (it can measure the amount of skin moisture from 0% to 99.9%), because of its fast,
      easy and reliable use, low cost, and its ability to measure in many anatomical regions.

      Materials provided in accordance with the procurement procedure of the institution where the
      research was conducted and used in patient care during the data collection phase were
      preferred as consumable materials.

      Researchers do not have any conflict of interest with companies regarding the preference of
      these materials. The consumables that are still used in the institution.
    

Intervention name(s): Replacement every 24 hours; Replacement every 12 hours
Intervention type(s): Procedure; Procedure
Intervention description(s): Processing Steps:
The monitoring electrodes were not replaced for 24 hours, the electrodes were removed at the end of 24 hours. During the 24-hour follow-up, patients whose electrodes were removed for any reason were excluded from the sample.
Immediately after the drying, skin moisture measurement was made in the right 2nd intercostal space (ICA), left 2nd ICA, and midclavicular 5th ICA regions.
The skin condition was evaluated from the areas monitored using the skin condition score by the researcher and another independent observer.
The data were recorded.; Processing Steps:
Monitoring electrodes were removed at the end of the 12th hour. When removing the monitoring electrodes, the area was first wetted using a disinfectant and dried using a sponge after removing the electrodes.
Immediately after the drying, skin moisture measurement was made in the right 2nd ICA, left 2nd ICA and midclavicular 5th ICA regions.
The skin condition was evaluated from these areas monitored using the skin condition score by the researcher and another independent observer.
Monitored again.
Monitoring electrodes were removed at the end of the 24th hour. Cleaning and drying were done immediately after removal.
Immediately after drying, skin moisture was measured from the monitored areas.
The skin condition was evaluated from the areas monitored using the skin condition score by the researcher and another independent observer.
The data were recorded.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Infant; Moisture; Monitoring; Pediatric Intensive Care; Skin