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 with the mother has been shown to maintain skin temperature regulation of the newborn, increase initiation of successful breast feeding, and ease the transition for intrauterine to extra-uterine life. The practice of skin to skin (also called Kangaroo Care-KC) has been adopted in our setting with vaginal deliveries at the rate of 75% of all vaginal deliveries participating in skin-to-skin mother baby care during calendar year 2010. The staff started to initiate KC in the PACU of the institution to provide all the benefits to the mother who had c/sections.

Proposed change: Before the initiation of skin to skin in the PACU infants had been removed from the warmer after being wrapped in warm blankets with a hat applied and given to the mother to hold or breast feed. This was not satisfying to the staff. Staff stated that if the vaginal birth infant could benefit then we should adopt the practice with the c/section. The process is now to have the chest/breast exposed and the infant with diaper and hat placed skin to skin and warm blankets applied to cover the back of the infant before leaving the OR

Implementation, outcomes and evaluation: The implementation was started by staff nurses using evidence based practice of KC being best for the newborn. Staff began by placing the infant skin to skin after moving the mother from the OR table to hospital bed. Both are transported to the PACU and initial checks are preformed and a baseline set of vitals are obtained on the infant. The mother baby 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 KC with their next delivery.

Implications for nursing practice: Empowering nurses to change practice to overcome traditional barriers of medical care to promote the empowerment of motherhood.

Keywords: Kangaroo Care; Cesarean Section