The Pēpi Splint Project Protocol

Project Summary Iatrogenic skin injury in hospitalised babies is common. Most babies who are admitted to a Neonatal Intensive Care Unit require a peripheral intravenous catheter (PIVC) for fluids, medication and nutrition. PIVCs (drips) are placed inside a vein and are the most commonly used device in unwell babies, with many babies requiring multiple drips. PIVCs are secured to the baby’s limb using splints and adhesive dressings. Removing the adhesive dressing (Elastoplast) frequently tears the fragile neonatal skin, causing pain, increasing the risk of infection and possibly lasting skin damage. Following a traumatic event experienced by a baby, whānau and staff within the Neonatal Intensive Care Unit at Waikato Hospital. We sought to design a new splint. The Pēpi Splint is made from medical silicone. It secures the PIVC to the baby without the need for adhesive dressings to be applied to the baby’s skin. We propose a stepwise investigation. The first phase is a prospective intervention proof-of concept pilot study to determine the effectiveness and acceptability of the Pēpi Split. We will recruit 30 Neonatal babies > 1000g who will require a PIVC as part of routine treatment in the Wellington Regional Hospital Neonatal Intensive Care Unit. Babies enrolled in the study will be cared for in the same way as those not in the study, with the addition of the Pēpi Splint. The study will run for as long as the Pēpi Splint remains in place. We estimate this period will vary between babies from 12 to 72 hours. Data will be collected from clinicians about the effectiveness and from the parents about the acceptability of the Pēpi Splint. These data will later be analysed by the Steering Committee. If the Pēpi Splint is found to be effective and acceptable parents, we may proceed to a randomised controlled trial. It is possible that the we will be able to considerably reduce the incidence of iatrogenic skin injuries in one of our most vulnerable populations, medically fragile babies.