Improving Early Initiation of Skin-to-Skin Contact Among Newborns Delivered Vaginally at a Tertiary Care Hospital: A Quality Improvement Study

Q4 Medicine Journal of Neonatology Pub Date : 2024-01-10 DOI:10.1177/09732179231218059
Anish Sinha, Reshma Pujara, Shradha Patel, D. Patel, S. Nimbalkar
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Abstract

Introduction: WHO and UNICEF recommend initiating early skin-to-skin contact (SSC) of newborns as an important intervention to reduce neonatal mortality. In India, it has been reported that only 15% of babies receive early SSC, and at our institution, only 22% of stable babies delivered vaginally were receiving SSC at birth. Aim: To increase the early initiation of SSC practice in neonates born through vaginal delivery ≥36 weeks from the observed baseline of 22% to ≥85% over 3 months. Methods: The study was conducted in the labor room of a tertiary care hospital over 3 months (December 2022 to February 2023) and a sustenance phase from April 2023 to June 2023. A root cause analysis was done using the fishbone framework, focusing on barriers related to mothers, hospital staff, policy, place, and practices. Based on this, a comprehensive early initiation of SSC intervention was planned utilizing Plan-Do-Study-Act cycles. Results: At the end of the three months, we achieved 100% compliance in the early initiation of SSC from a baseline of 22%, and the same compliance was maintained during the sustenance phase. The line chart used for interpretation showed an increase in compliance and increased duration of SSC till early initiation of breastfeeding was established.
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改善一家三级医院经阴道分娩新生儿的早期皮肤接触:质量改进研究
导言:世界卫生组织和联合国儿童基金会建议将新生儿早期皮肤接触(SSC)作为降低新生儿死亡率的一项重要干预措施。据报道,在印度,仅有 15%的婴儿接受了早期皮肤接触,而在我们医院,仅有 22% 经阴道分娩的稳定婴儿在出生时接受了皮肤接触。目的:在 3 个月内,将阴道分娩≥36 周的新生儿早期开始接受 SSC 的比例从观察到的基线 22% 提高到≥85%。研究方法研究在一家三级医院的产房进行,为期 3 个月(2022 年 12 月至 2023 年 2 月),2023 年 4 月至 2023 年 6 月为维持阶段。采用鱼骨框架进行了根本原因分析,重点关注与母亲、医院员工、政策、场所和实践有关的障碍。在此基础上,利用 "计划-实施-研究-行动 "周期,规划了全面的早期启动 SSC 干预措施。结果:在三个月结束时,我们实现了 100%的 SSC 早期干预达标率,而基线为 22%,在维持阶段也保持了同样的达标率。用于解释的折线图显示,在早期开始母乳喂养之前,母乳喂养的依从性和持续时间都在增加。
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来源期刊
Journal of Neonatology
Journal of Neonatology Medicine-Pediatrics, Perinatology and Child Health
CiteScore
0.30
自引率
0.00%
发文量
55
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