Research Article
Have access already?
Get access to this article:
Or get access to the particular issue:
- Perpetual access Add to cart ($49.95)
Or get access to the entire journal:
Advertisement
Abstract
Background
Early skin-to-skin care (SSC) has been shown to improve outcomes after preterm birth, including improved clinical stability and establishment of breastfeeding. Recent evidence suggests the most unstable infants get the most benefit, yet these infants are not consistently offered opportunities for SSC because of safety concerns and discomfort of the care team.
Purpose
To identify barriers and implement a multidimensional approach to increase SSC within the first 72 hours of life among infants born less than 28 weeks' gestation and less than 1,000 g in a Level IV university-based regional intensive care nursery.
Methods
Using Institute of Healthcare Improvement quality improvement methodology, a multidisciplinary team identified barriers to SSC and developed targeted interventions, including a unit-specific protocol; widespread parent, staff, and provider education; and an infant readiness checklist. The primary outcome was the rate of SSC within 72 hours. The balancing measure was the rate of severe intraventricular hemorrhage (IVH). Data were collected from monthly chart review and analyzed with statistical process control charts. The aim was to increase SSC within 72 hours of birth from 7 percent to greater than 80 percent within 12 months for infants born less than 28 weeks' gestation or less than 1,000 g.
Results
Between June 2017 and December 2019, there were 52 extremely preterm infants included in the project (15 preintervention and 37 postintervention). The rate of SSC within the first 72 hours increased from 7 to 84 percent. There has been no increase in any or severe IVH during the project period despite the increased rate of SSC.
Implications for Practice
Implementation of multidimensional, multidisciplinary interventions for reducing barriers to early SSC in extremely preterm infants resulted in rapid adoption of SSC in the first 72 hours of life without increasing severe IVH in this high-risk population.
Article usage
| Period | Abstract | Full | Total | |
|---|---|---|---|---|
| Apr 2024 | 85 | 6 | 9 | 100 |
| Mar 2024 | 89 | 4 | 5 | 98 |
| Feb 2024 | 64 | 7 | 8 | 79 |
| Jan 2024 | 99 | 8 | 4 | 111 |
| Dec 2023 | 62 | 11 | 6 | 79 |
| Nov 2023 | 89 | 7 | 7 | 103 |
| Oct 2023 | 57 | 7 | 2 | 66 |
| Sep 2023 | 43 | 3 | 2 | 48 |
| Aug 2023 | 69 | 1 | 4 | 74 |
| Jul 2023 | 61 | 4 | 3 | 68 |
| Jun 2023 | 79 | 2 | 3 | 84 |
| May 2023 | 89 | 8 | 6 | 103 |
| Apr 2023 | 132 | 7 | 7 | 146 |
| Mar 2023 | 137 | 10 | 7 | 154 |
| Feb 2023 | 112 | 17 | 13 | 142 |
| Jan 2023 | 65 | 9 | 2 | 76 |
| Dec 2022 | 97 | 9 | 5 | 111 |
| Nov 2022 | 250 | 5 | 3 | 258 |
| Oct 2022 | 113 | 16 | 8 | 137 |
| Sep 2022 | 110 | 11 | 10 | 131 |
| Aug 2022 | 74 | 5 | 6 | 85 |
| Jul 2022 | 90 | 9 | 7 | 106 |
| Jun 2022 | 127 | 10 | 9 | 146 |
| May 2022 | 112 | 12 | 16 | 140 |
| Apr 2022 | 204 | 8 | 11 | 223 |
| Mar 2022 | 249 | 9 | 9 | 267 |
| Feb 2022 | 198 | 14 | 14 | 226 |
| Jan 2022 | 153 | 10 | 8 | 171 |
| Dec 2021 | 92 | 3 | 6 | 101 |
| Nov 2021 | 143 | 18 | 20 | 181 |
| Oct 2021 | 411 | 16 | 15 | 442 |
| Sep 2021 | 1507 | 17 | 14 | 1538 |
| Aug 2021 | 1301 | 42 | 50 | 1393 |
| Jul 2021 | 17 | 3 | 3 | 23 |
Cited by