To have 100% of medically stable mothers and infants spend greater than 30 minutes skin-to-skin within the first hour of birth.
Quality improvement implementation project.
Mother/infant dyads immediately after birth, labor and delivery nurses, and respiratory therapists present in the first hour after delivery.
The quality improvement method used at this hospital was MAP-IT. Mobilize: An interdisciplinary project leadership team was formed and sustained. The team included the birth center nurse manager, educator, neonatal resuscitation team respiratory therapist, a lactation consultant, and a registered nurse project leader. Assess: Skin-to-skin frequency and registered nurse practices and knowledge were assessed pre-, during, and postimplementation. Frequency of timed skin-to-skin contact was recorded in patients’ electronic health records. Plan: The team developed a plan with short- and long-term objectives summarized using a logic model. Implementation: Nursing and respiratory staff members were educated about benefits of mother/infant skin-to-skin contact, strategies to implement the practice, and the process for accurate documentation. Track: Monthly data were evaluated and project adjustments made. Graphs provided visual information to staff and leadership about the steady improvement in accurate documentation and rates of skin-to- skin contact.
Accurate skin-to-skin documentation increased from 40% to 90% over a 6-month period. Skin-to-skin contact for 30 minutes or more increased from 58% to 83%.
Conclusion/Implications for Nursing Practice
A multidisciplinary team with a comprehensive plan and sustained focus led to more frequent skin-to-skin contact.