Purpose for the Program
Kangaroo care is recommended in the Guidelines for Perinatal Care for stable newborns. The act of placing the infant skin-to-skin (also called Kangaroo care) with the mother has been shown to maintain skin temperature regulation of the newborn, increase initiation of successful breastfeeding, and ease the transition for intrauterine to extrauterine life. The practice of Kangaroo care has been well adopted in our setting. During 2010, 75% of all mothers who gave birth vaginally participated in skin-to-skin care. The staff started to initiate Kangaroo care in the postanesthesia care unit to provide all the benefits to the mothers who had cesarean births.
Before the initiation of skin-to-skin in the postanesthesia care unit, infants had been removed from the warmer after being wrapped with warm blankets and a hat and given to the mother to hold or breastfeed. This process was not satisfying to the staff. The staff stated that if the vaginal birth infant could benefit from skin-to-skin, then we should adopt the practice with the cesarean birth infant. The process before leaving the operating room is to now initiate skin-to-skin with the infant (who is dressed only with a diaper and hat) and apply warm blankets against the back of the infant while leaving its chest exposed.
Implementation, Outcomes, and Evaluation
The implementation was started by staff nurses who considered the evidence-based practice of Kangaroo care to be best for the newborn. Staff began by placing the infant skin-to-skin after moving the mother from the operating room table to a hospital bed. Both are transported to the postanesthesia care unit, initial checks are preformed, and a baseline set of vitals is obtained on the infant. The mother-infant pair is left skin-to-skin for the next 60 to 90 minutes. Outcomes have been measured by patient satisfaction and stable infant temperatures during the time frame. Patients report they would initiate Kangaroo care with their next birth.
Implications for Nursing Practice
Empowering nurses to change practice to overcome traditional barriers of medical care to promote the empowerment of motherhood.