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Skin to Skin in the Operating Room - It Takes a Village
Title: Skin to Skin in the Operating Room - It Takes a Village
- Identify two barriers to skin to skin contact in the OR.
- Discuss ways to incorporate multidisciplinary members of the OR team in establishing early initiation of skin to skin contact.
- Describe the impact of prenatal and pre-operative breastfeeding education on early skin to skin contact and breastfeeding success rates.
Early skin to skin contact between a mother and her infant has been studied and shown to improve outcomes for both mother and baby. As a hospital that received the Baby-Friendly designation in April 2010, we are well aware of the benefits of skin to skin contact. During our journey to become Baby-Friendly, the topic of skin to skin contact was researched and discussed, as we worked to develop a plan to implement skin to skin contact at birth. At the time of our site visit, we had successfully implemented skin to skin contact immediately after delivery for vaginal deliveries and in the recovery room for c-section deliveries.
Proposed change:
As professionals, we are constantly evaluating our practices and looking for ways to improve. During our Baby-Friendly journey, there was resistance to the idea of implementing skin to skin contact in the OR from all disciplines. As time went on, we realized that implementing skin to skin contact in the OR was the next step in providing the optimal care for our mothers and babies. In order to do that, we would need support from all members of the interdisciplinary team.
Implementation, outcomes and evaluation:
The first step began with a journal club article and discussion on implementing skin to skin in the OR. Barriers were identified and a plan to overcome them had begun. The following week, 2 staff nurses took it upon themselves to try skin to skin contact in the OR to see how it could be done. From there, the topic became an agenda item for both the OB service line meeting and the Perinatal Safety and Satisfaction interdisciplinary committee for further discussion. Following that, a presentation was made at the Anesthesia service line meeting to provide education and gain their support. We incorporated the topic of skin to skin contact into our prenatal breastfeeding classes and the nurses introduce it on admission to L&D. Additionally, changes were made to our electronic medical record to provide documentation of skin to skin contact in the OR and allow us to track the data.
Implications for nursing practice:
Change is difficult for any intervention you are looking to implement. By getting support from all stakeholders throughout the process, keeping everyone engaged and taking it one step at a time, change is possible. As a result, we have implemented skin to skin contact in the operating room.
Keywords: skin to skin contact, cesarean section, interdisciplinary teamwork