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Sunday, September 26, 2010
Title: Kangaroo Care: A Solution to Minimize Mother and Baby Separation
Discipline: Childbearing (CB)
Learning Objectives:
Submission Description:- Describe the benefits of kangaroo care when implemented shortly after birth
- Discuss the strategies used to implement evidence into practice
- Discuss how educating nurses about kangaroo care impacted nursing practice
Separation of mother and baby after childbirth has been found to negatively impact maternal and newborn outcomes. Kangaroo care is one strategy to keep mother and baby together and promote thermoregulation, easier transition to extrauterine life, mother-infant attachment, increase in breastfeeding, reduction in crying, and the stabilization of blood glucose, core body temperature, heart rate, and blood pressure. Two projects aimed at minimizing mother baby separation by use of kangaroo care have been completed at a 572 bed community teaching hospital having approximately 3,000 births annually. The first evidence-based practice (EBP) project was completed by a team of postpartum nurses. The results of the project were shared with the labor and delivery nurses and implemented in a similar fashion on the labor and delivery unit. The purpose of the study was to investigate whether providing labor and delivery nurses with education, about “how to” provide kangaroo care and its benefits for the term infant, would increase nurses’ implementation of kangaroo care shortly after birth. The Johns Hopkins Nursing EBP Model was used to guide a team of five labor and delivery nurses through the EBP process. The original literature review was updated by the project team and recommendations made to encourage the use of kangaroo care immediately following childbirth. The team’s translation strategies included changes to nursing policy with inclusion of a procedure for kangaroo care, implementation of patient education brochures from the original EBP practice team, scripted patient education and mandatory nurse education. Education provided to the nursing staff included a self-learning packet that required reading two articles about kangaroo care following childbirth and the policy. Verification of learning was completed through three written tests (one test for each article and one test for the policy). Each EBP team member was assigned a group of nurses to provide with written and scripted education and a demonstration of the procedure. All nurses were required to participate in the education. At 6 weeks, the educators met with their assigned group members to answer questions and address issues. A pre versus post quasi-experimental design was used to evaluate the nurses’ practice of implementing kangaroo care in the birthing room pre- and post-education. A self-report survey was administered, before education and 3 months after education was completed, to identify changes in practice. Of the unit’s 44 nurses, 38 voluntarily participated in the pre- and post-education survey. Variables of age, years in nursing, years in labor and delivery nursing and education were collected. These variables were not related to the outcomes. Following education the nurses’ use of kangaroo care was significantly increased. A Mann-Whitney U test demonstrated that implementation of kangaroo care was significantly increased post education (p < 0.05). Nurses have changed practice however measurement of sustainability will be important. Future research efforts to determine mother’s experience would also be beneficial. By sharing the science of kangaroo care, two nursing units have found a solution to minimize mother baby separation.