Diaper dermatitis, an acute inflammatory reaction of the skin, is one of the most common forms of dermatitis among neonatal and pediatric patients. The problem addressed in this quality improvement project was the absence of an evidence-based practice (EBP) guideline for perineal care which resulted in 4 unexpected cases of diaper dermatitis per 100 hospital days at a non free standing children's hospital. Framed within Rosswurm and Larrabee's model for EBP, the purpose of this project was to develop an educational initiative encompassing an EBP guideline for perineal care, an educational curriculum plan for staff members, and a Power Point presentation to leadership on the educational initiative. A master's prepared pediatric nurse educator served as content expert to evaluate the educational curriculum plan using a dichotomous scale (not met = 1/met = 2) format for the 8 objectives. Each of the 8 items was scored a 2, meaning all objectives were covered in the curriculum. The expert recommended that the methods and procedures used should be placed in the employee orientation process. The educational initiative was presented to the leadership team (n = 11) who evaluated the project using a Likert-type scale ranging from 1 (strongly disagree) to 5 (strongly agree). An average score of 5 was given, revealing that the objectives of the presentation were met. The leadership team recommended that the project be implemented. Positive social change may result from this DNP project by facilitating neonatal/pediatric skin integrity through evidence-based nursing care thus promoting patient well-being and prevention of hospital acquired infections.

M.Tech. / Diaper dermatitis (Nappy Rash) is an acute inflammation of the skin in the diaper area and is the most common cutaneous disease among infants and children (Concannon et al., 2001). It is estimated that 7% - 35% of diaper wearing infants are affected by Diaper dermatitis during the period of wearing diapers (Barkin and Rosen, 2003). The exact prevalence is not known as many cases are selfmedicated by parents or guardians (Wolf et al., 2000). Diaper dermatitis causes severe discomfort to the infants as well as anxiety and worry for the parents. Diaper dermatitis is characterised by redness, inflammation, dryness, scaling, itching, irritability, pain, satellite lesions, papulovesicular or pustular eruptions, and in severe cases ulceration of the skin (Visscher and Hoath, 2006). This study aimed to assess the efficacy of a Homoeopathic complex cream as a topical treatment for Diaper dermatitis. The complex consisted of Atropa belladonna 6cH, Calendula officinalis D1 and Sulphuricum acidum 6cH. Madaji milking cream was used as a base which contained: chlorhexidene; vitamin E; and lanolin. The treatment group received the medicated Madaji milking cream whereas the control group received the unmedicated Madaji milking cream. The Diaper dermatitis was evaluated using a 4-Point Grading Scale (Appendix D) and The Modified Lund and Browder Chart (Appendix E). Forty participants who met the inclusion and exclusion criteria were recruited to participate in this double blind control study by means of advertisements (Appendix A) that were placed on notice boards at the various campuses of the University of Johannesburg, nursery schools and hospitals, with relevant permission given. Participants were also recruited via word of mouth. Once participants were accepted into the study they were allocated to either Group A or Group B using matched pairs according to severity in order to ensure equal v distribution in both groups. There were 20 participants in each group. Group A was the treatment group which received the medicated Madaji milking cream. Group B was the control group which received the unmedicated Madaji cream. The study was completed over a seven day period. The ten areas most commonly affected by Diaper dermatitis were evaluated on the initial visit, day two, day four and day seven.