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Sustaining prolonged kangaroo mother care in stable low birthweight babies over 2 years in a predominant outborn unit: a quality improvement approach

BACKGROUND: Kangaroo mother care (KMC) is a proven intervention for improving intact survival in low birthweight babies. Despite the evidence, its adoption and implementation have been low. Availability of mothers for the first few days of life is a specific challenge at outborn units. We used a qua...

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Autores principales: Ramachandrappa, Gayathri, Somasekhara Aradhya, Abhishek, Mercy, Latha, Kumar, Anil, Venkatagiri, Praveen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9092162/
https://www.ncbi.nlm.nih.gov/pubmed/35545269
http://dx.doi.org/10.1136/bmjoq-2021-001771
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author Ramachandrappa, Gayathri
Somasekhara Aradhya, Abhishek
Mercy, Latha
Kumar, Anil
Venkatagiri, Praveen
author_facet Ramachandrappa, Gayathri
Somasekhara Aradhya, Abhishek
Mercy, Latha
Kumar, Anil
Venkatagiri, Praveen
author_sort Ramachandrappa, Gayathri
collection PubMed
description BACKGROUND: Kangaroo mother care (KMC) is a proven intervention for improving intact survival in low birthweight babies. Despite the evidence, its adoption and implementation have been low. Availability of mothers for the first few days of life is a specific challenge at outborn units. We used a quality improvement (QI) approach to implement and sustain KMC in stable low birthweight babies (<2000 g) from a baseline of 2.7 hours/baby/day to 6 hours/baby/day (prolonged KMC) over a period of 2 years in our unit through a series of Plan-Do-Study-Act (PDSA) cycles. METHODS: All babies with birth weight <2000 g not on any respiratory support or jaundice were eligible. The key quantitative outcome was KMC hours/baby/day. A QI team consisting of nurses, nursing in charge and consultants of the unit was formed. The potential barriers for prolonged KMC were evaluated using fishbone analysis. A variety of parent-centric measures (provision of bed to mothers apart from KMC chairs, foster KMC, structured KMC counselling through a video, making KMC an integral part of treatment order) were introduced and subsequently tested by multiple PDSA cycles. Data on the duration of KMC per day were measured by bedside nurses on a daily basis. RESULTS: A total of 134 mother–baby dyads were enrolled over 2 years. The mean gestation (SD) and mean birth weight (SD) were 33 (2) weeks and 1557 (295) g, respectively. 78 (58%) babies were outborns. We implemented prolonged KMC over 9 months and sustained it over the next 18 months. KMC duration increased from a median of 2.7 hours/baby/day from baseline to a median of 7.4 hours/baby/day after implementation. CONCLUSIONS: Prolonged KMC could be implemented and sustained over 2 years by implementing parent-centric best practices even in a predominant outborn unit.
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spelling pubmed-90921622022-05-27 Sustaining prolonged kangaroo mother care in stable low birthweight babies over 2 years in a predominant outborn unit: a quality improvement approach Ramachandrappa, Gayathri Somasekhara Aradhya, Abhishek Mercy, Latha Kumar, Anil Venkatagiri, Praveen BMJ Open Qual Quality Improvement Report BACKGROUND: Kangaroo mother care (KMC) is a proven intervention for improving intact survival in low birthweight babies. Despite the evidence, its adoption and implementation have been low. Availability of mothers for the first few days of life is a specific challenge at outborn units. We used a quality improvement (QI) approach to implement and sustain KMC in stable low birthweight babies (<2000 g) from a baseline of 2.7 hours/baby/day to 6 hours/baby/day (prolonged KMC) over a period of 2 years in our unit through a series of Plan-Do-Study-Act (PDSA) cycles. METHODS: All babies with birth weight <2000 g not on any respiratory support or jaundice were eligible. The key quantitative outcome was KMC hours/baby/day. A QI team consisting of nurses, nursing in charge and consultants of the unit was formed. The potential barriers for prolonged KMC were evaluated using fishbone analysis. A variety of parent-centric measures (provision of bed to mothers apart from KMC chairs, foster KMC, structured KMC counselling through a video, making KMC an integral part of treatment order) were introduced and subsequently tested by multiple PDSA cycles. Data on the duration of KMC per day were measured by bedside nurses on a daily basis. RESULTS: A total of 134 mother–baby dyads were enrolled over 2 years. The mean gestation (SD) and mean birth weight (SD) were 33 (2) weeks and 1557 (295) g, respectively. 78 (58%) babies were outborns. We implemented prolonged KMC over 9 months and sustained it over the next 18 months. KMC duration increased from a median of 2.7 hours/baby/day from baseline to a median of 7.4 hours/baby/day after implementation. CONCLUSIONS: Prolonged KMC could be implemented and sustained over 2 years by implementing parent-centric best practices even in a predominant outborn unit. BMJ Publishing Group 2022-05-10 /pmc/articles/PMC9092162/ /pubmed/35545269 http://dx.doi.org/10.1136/bmjoq-2021-001771 Text en © Author(s) (or their employer(s)) 2022. 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
Ramachandrappa, Gayathri
Somasekhara Aradhya, Abhishek
Mercy, Latha
Kumar, Anil
Venkatagiri, Praveen
Sustaining prolonged kangaroo mother care in stable low birthweight babies over 2 years in a predominant outborn unit: a quality improvement approach
title Sustaining prolonged kangaroo mother care in stable low birthweight babies over 2 years in a predominant outborn unit: a quality improvement approach
title_full Sustaining prolonged kangaroo mother care in stable low birthweight babies over 2 years in a predominant outborn unit: a quality improvement approach
title_fullStr Sustaining prolonged kangaroo mother care in stable low birthweight babies over 2 years in a predominant outborn unit: a quality improvement approach
title_full_unstemmed Sustaining prolonged kangaroo mother care in stable low birthweight babies over 2 years in a predominant outborn unit: a quality improvement approach
title_short Sustaining prolonged kangaroo mother care in stable low birthweight babies over 2 years in a predominant outborn unit: a quality improvement approach
title_sort sustaining prolonged kangaroo mother care in stable low birthweight babies over 2 years in a predominant outborn unit: a quality improvement approach
topic Quality Improvement Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9092162/
https://www.ncbi.nlm.nih.gov/pubmed/35545269
http://dx.doi.org/10.1136/bmjoq-2021-001771
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