Increasing Skin-to-Skin in a Level IV NICU: A Quality Improvement Project

Abstract

Purpose To evaluate the effect of a bundled intervention on the number of skin-to-skin (“kangaroo care”) events occurring in a level IV NICU. Design A quality improvement effort centering around the introduction of an intervention bundle intended to safely increase the rate of skin-to-skin holding. Rates of unplanned extubations were recorded as a balancing measure to estimate safety. Sample All infants admitted to the NICU from December 2017 through September 2019 were included. The “preintervention” period was the 6 months prior to the initiation of the intervention bundle (December 2017–May 2018). Results The absolute number of skin-to-skin holds increased from the preintervention phase (range 7–28 holds/month, median 11 holds/month) to the postintervention phase (range 16–100 holds/month, median 55 holds/month). The total unplanned extubations showed no significant change between the preintervention and postintervention periods.

Disparities in Kangaroo Care for Premature Infants in the Neonatal Intensive Care Unit

“…27 Targeted parent education about the benefits of KC has been an important part of effective quality improvement efforts to improve rates of KC. [28][29][30] Parent education may be hampered by language barriers or ineffective communication because of parent educational level or other social factors. Possible strategies are policies that promote family-integrated approaches in which parents are seen as partners of the clinical staff 31 and that expect parents to be present for longer periods and transition to active caregivers, thus potentially removing many barriers to visitation and KC.…”

“…Education of clinical staff and institution of the clear guidelines around KC have been shown to be effective in improving rates of KC. 28,30,38 National quality standards should include measures of family-integrated developmental care and direct measures of disparate care.…”