A Multi Discipinary Approach To Improving Skin To Skin Contact Immediately After Birth

Purpose for the program: Educate labor and delivery staff about the complex institutional changes necessary to increase skin to skin rates based on Baby Friendly crieteria

Proposed change: Improve rates for skin to skin contact in the labor and delivery room, ultimately improve breastfeed rates in the community

Implementation, outcomes and evaluation: Survey nursing staff for baseline of current skin to skin practice.Identify barriers,team development including all departments associated and plans to remove barriers. Continue to monitor skin to skin rates , survey staff and patients.

Implications for nursing practice: Nursing practice to improve skin to skin contact immediately after delivery, and institution procedures requiring change. Success of improving skin to skin rates in labor and delivery, depends on the cooperation and flexability of every discipline involved in the care of mothers and newborns.

Keywords: Breastfeeding,skin to skin, maternal -infant bonding, teamwork,Baby Friendly

      Establishing a major practice change in a large labor and delivery unit,with more than 6,000 birth annually, proved a difficult task for nursing alone. Meeting the goal of 90% of healthy newborns remaining  undisturbed for at least one hour after birth in direct skin to skin contact with the mother became a major challange.  Since 2009, nursing staff initatives to improve skin to skin in labor and delivery proved only limited success. A team formed to take on the task of defining guidelines of skin to skin contact began with pediatricians, lactation specialists, postpartum,and labor and delivery staff. As challanges and barriers were identified, input from anesthesia, administration, information services, clerical staff, as well as hospital clinics and community services became essential.

     This presentation will highlight the paths traveled to achieve success,crediting teamwork on all levels to implement practice change. Nursing champions for skin to skin, reached out to ancillary personnel in discipines affecting newborn care. Barriers identified by staff survey, observation and trial and error were addressed individually. Labor and delivery nursing staff took on the challenge of keeping mothers and babies together for one hour after birth, and with the dedication of all supporting departments they soon encountered success.

     The results are impressive ,skin to skin rates increased dramatically in a relatively short period of time and best of all the patients and nurses are expressing satisfaction about these changes. Statistics collected demonstrate an impressive improvement in skin to skin rates.  Patient and staff surveys support  growing satisfaction with the changes implemented.  Involving all stakeholders helped to identify and address barriers ,supporting the sustainability of our new practice.