Cargando…

Sustaining extended Kangaroo mother care in stable low birthweight babies in NICU: a quality improvement collaborative of six centres of Karnataka

BACKGROUND: Kangaroo mother care (KMC) is a proven intervention for intact survival in preterms. Despite evidence, its adoption has been low. We used a point of care quality improvement (QI) approach to implement and sustain KMC in stable low birthweight babies from a baseline of 1.5 hours/baby/day...

Descripción completa

Detalles Bibliográficos
Autores principales: Murthy, Raksha, Kallesh, Anil, Somasekhara Aradhya, Abhishek, Bharadwaj, Shruthi K, Venkatagiri, Praveen, Jagadish, Meena, Rao, Poornachandra, Chandramouli, Divya, Hema, Doddarangaiah, Chaithra, S N, Glory, Hellan, Purkayastha, Jayashree
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10603408/
https://www.ncbi.nlm.nih.gov/pubmed/37863504
http://dx.doi.org/10.1136/bmjoq-2023-002307
_version_ 1785126599273742336
author Murthy, Raksha
Kallesh, Anil
Somasekhara Aradhya, Abhishek
Bharadwaj, Shruthi K
Venkatagiri, Praveen
Jagadish, Meena
Rao, Poornachandra
Chandramouli, Divya
Hema, Doddarangaiah
Chaithra, S N
Glory, Hellan
Purkayastha, Jayashree
author_facet Murthy, Raksha
Kallesh, Anil
Somasekhara Aradhya, Abhishek
Bharadwaj, Shruthi K
Venkatagiri, Praveen
Jagadish, Meena
Rao, Poornachandra
Chandramouli, Divya
Hema, Doddarangaiah
Chaithra, S N
Glory, Hellan
Purkayastha, Jayashree
author_sort Murthy, Raksha
collection PubMed
description BACKGROUND: Kangaroo mother care (KMC) is a proven intervention for intact survival in preterms. Despite evidence, its adoption has been low. We used a point of care quality improvement (QI) approach to implement and sustain KMC in stable low birthweight babies from a baseline of 1.5 hours/baby/day to above 4 hours/baby/day through a series of plan-do-study-act (PDSA) cycles over a period of 53 weeks. METHODS: All babies with birth weight <2000 g not on any respiratory support or phototherapy and or umbilical lines were eligible. The key quantitative outcome was KMC hours/baby/day. A QI collaborative was formed between six centres of Karnataka mentored by a team with a previous QI experience on KMC. The potential barriers for extended KMC were evaluated using fishbone analysis. Baseline data were collected over 3 weeks. A bundled approach consisting of a variety of parent centric measures (such as staff awareness, making KMC an integral part of treatment order, foster KMC, awareness sessions to parents weekly, recognising KMC champions) was employed in multiple PDSA cycles. The data were aggregated biweekly and the teams shared their implementation experiences monthly. RESULTS: A total of 1443 parent–baby dyads were enrolled. The majority barriers were similar across the centres. Bundled approach incorporating foster KMC helped in the quick implementation of KMC even in outborns. Parental involvement and empowering nurses helped in sustaining KMC. Two centres had KMC rates above 10 hours/baby/day, while remaining four centres had KMC rates sustained above 6 hours/baby/day. Cross-learnings from team meetings helped to sustain efforts. Extended KMC could be implemented and sustained by low intensity training and QI collaboration. CONCLUSIONS: Formation of a QI collaborative with mentoring helped in scaling implementation of extended KMC. Extended KMC could be implemented by parent centric best practices in all the centres without any additional need of resources.
format Online
Article
Text
id pubmed-10603408
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-106034082023-10-28 Sustaining extended Kangaroo mother care in stable low birthweight babies in NICU: a quality improvement collaborative of six centres of Karnataka Murthy, Raksha Kallesh, Anil Somasekhara Aradhya, Abhishek Bharadwaj, Shruthi K Venkatagiri, Praveen Jagadish, Meena Rao, Poornachandra Chandramouli, Divya Hema, Doddarangaiah Chaithra, S N Glory, Hellan Purkayastha, Jayashree BMJ Open Qual Quality Improvement Report BACKGROUND: Kangaroo mother care (KMC) is a proven intervention for intact survival in preterms. Despite evidence, its adoption has been low. We used a point of care quality improvement (QI) approach to implement and sustain KMC in stable low birthweight babies from a baseline of 1.5 hours/baby/day to above 4 hours/baby/day through a series of plan-do-study-act (PDSA) cycles over a period of 53 weeks. METHODS: All babies with birth weight <2000 g not on any respiratory support or phototherapy and or umbilical lines were eligible. The key quantitative outcome was KMC hours/baby/day. A QI collaborative was formed between six centres of Karnataka mentored by a team with a previous QI experience on KMC. The potential barriers for extended KMC were evaluated using fishbone analysis. Baseline data were collected over 3 weeks. A bundled approach consisting of a variety of parent centric measures (such as staff awareness, making KMC an integral part of treatment order, foster KMC, awareness sessions to parents weekly, recognising KMC champions) was employed in multiple PDSA cycles. The data were aggregated biweekly and the teams shared their implementation experiences monthly. RESULTS: A total of 1443 parent–baby dyads were enrolled. The majority barriers were similar across the centres. Bundled approach incorporating foster KMC helped in the quick implementation of KMC even in outborns. Parental involvement and empowering nurses helped in sustaining KMC. Two centres had KMC rates above 10 hours/baby/day, while remaining four centres had KMC rates sustained above 6 hours/baby/day. Cross-learnings from team meetings helped to sustain efforts. Extended KMC could be implemented and sustained by low intensity training and QI collaboration. CONCLUSIONS: Formation of a QI collaborative with mentoring helped in scaling implementation of extended KMC. Extended KMC could be implemented by parent centric best practices in all the centres without any additional need of resources. BMJ Publishing Group 2023-10-17 /pmc/articles/PMC10603408/ /pubmed/37863504 http://dx.doi.org/10.1136/bmjoq-2023-002307 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Quality Improvement Report
Murthy, Raksha
Kallesh, Anil
Somasekhara Aradhya, Abhishek
Bharadwaj, Shruthi K
Venkatagiri, Praveen
Jagadish, Meena
Rao, Poornachandra
Chandramouli, Divya
Hema, Doddarangaiah
Chaithra, S N
Glory, Hellan
Purkayastha, Jayashree
Sustaining extended Kangaroo mother care in stable low birthweight babies in NICU: a quality improvement collaborative of six centres of Karnataka
title Sustaining extended Kangaroo mother care in stable low birthweight babies in NICU: a quality improvement collaborative of six centres of Karnataka
title_full Sustaining extended Kangaroo mother care in stable low birthweight babies in NICU: a quality improvement collaborative of six centres of Karnataka
title_fullStr Sustaining extended Kangaroo mother care in stable low birthweight babies in NICU: a quality improvement collaborative of six centres of Karnataka
title_full_unstemmed Sustaining extended Kangaroo mother care in stable low birthweight babies in NICU: a quality improvement collaborative of six centres of Karnataka
title_short Sustaining extended Kangaroo mother care in stable low birthweight babies in NICU: a quality improvement collaborative of six centres of Karnataka
title_sort sustaining extended kangaroo mother care in stable low birthweight babies in nicu: a quality improvement collaborative of six centres of karnataka
topic Quality Improvement Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10603408/
https://www.ncbi.nlm.nih.gov/pubmed/37863504
http://dx.doi.org/10.1136/bmjoq-2023-002307
work_keys_str_mv AT murthyraksha sustainingextendedkangaroomothercareinstablelowbirthweightbabiesinnicuaqualityimprovementcollaborativeofsixcentresofkarnataka
AT kalleshanil sustainingextendedkangaroomothercareinstablelowbirthweightbabiesinnicuaqualityimprovementcollaborativeofsixcentresofkarnataka
AT somasekharaaradhyaabhishek sustainingextendedkangaroomothercareinstablelowbirthweightbabiesinnicuaqualityimprovementcollaborativeofsixcentresofkarnataka
AT bharadwajshruthik sustainingextendedkangaroomothercareinstablelowbirthweightbabiesinnicuaqualityimprovementcollaborativeofsixcentresofkarnataka
AT venkatagiripraveen sustainingextendedkangaroomothercareinstablelowbirthweightbabiesinnicuaqualityimprovementcollaborativeofsixcentresofkarnataka
AT jagadishmeena sustainingextendedkangaroomothercareinstablelowbirthweightbabiesinnicuaqualityimprovementcollaborativeofsixcentresofkarnataka
AT raopoornachandra sustainingextendedkangaroomothercareinstablelowbirthweightbabiesinnicuaqualityimprovementcollaborativeofsixcentresofkarnataka
AT chandramoulidivya sustainingextendedkangaroomothercareinstablelowbirthweightbabiesinnicuaqualityimprovementcollaborativeofsixcentresofkarnataka
AT hemadoddarangaiah sustainingextendedkangaroomothercareinstablelowbirthweightbabiesinnicuaqualityimprovementcollaborativeofsixcentresofkarnataka
AT chaithrasn sustainingextendedkangaroomothercareinstablelowbirthweightbabiesinnicuaqualityimprovementcollaborativeofsixcentresofkarnataka
AT gloryhellan sustainingextendedkangaroomothercareinstablelowbirthweightbabiesinnicuaqualityimprovementcollaborativeofsixcentresofkarnataka
AT purkayasthajayashree sustainingextendedkangaroomothercareinstablelowbirthweightbabiesinnicuaqualityimprovementcollaborativeofsixcentresofkarnataka
AT sustainingextendedkangaroomothercareinstablelowbirthweightbabiesinnicuaqualityimprovementcollaborativeofsixcentresofkarnataka