Abstract
Objectives
To increase the duration of Kangaroo mother care (KMC) in preterm infants from an average of 3 hours/day to at least 6 hours/day over 7 weeks through a Quality improvement (QI) approach in a tertiary-care neonatal unit.
Methods
Preterm mother-infant dyads who were admitted in the Neonatal intensive care unit and KMC ward were enrolled in this study. A QI team comprising of nurses, nurse educators, resident physicians and nursing-in-charge of unit was formed. The potential barriers for prolonged KMC were evaluated using fish bone analysis. A variety of measures (allowing family members including male members during night for doing KMC, making KMC an integral part of treatment order, introducing the concept of weekly KMC champions, etc.) were introduced and subsequently tested by multiple Plan-do-study-act (PDSA) cycles. Data on duration of KMC per day was measured by bedside nurses on daily basis.
Results
20 eligible mother-infant dyads were studied during implementation period (50 d). The mean (SD) weight and gestation of infants were 1199 (356) g and 31.1 ( 2.3) wks, respectively. We achieved our goal by step-wise implementation of changes through construction of 3 PDSA cycles. The duration of KMC increased to 6 hours-a-day over a period of 7 weeks. Evaluation at 6 and 12 months in the post-implementation phase suggested sustenance of improved KMC duration up to 9 h/day in the unit.
Conclusions
Ongoing quality improvement measures increased the duration of KMC from a baseline of 3 h to 6 h in eligible preterm infants, and the results were sustained at 6–12 month.
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References
Engmann C, Wall S, Darmstadt G, Valsangkar B, Claeson M, Participants of the Istanbul KMC Acceleration Meeting. Consensus on Kangaroo mother care acceleration. Lancet. 2013;382:e26–7.
WHO Kangaroo Mother Care: A Practical Guide. WHO. Available from: https://doi.org/www.who.int/maternal_child_adolescent/documents/9241590351/en/. Accessed November 28, 2016.
Charpak N, Tessier R, Ruiz JG, Hernandez JT, Uriza F, Villegas J, et al. Twenty-year follow-up of kangaroo mother care versus traditional care. Pediatrics. 2016;e20162063.
Boundy EO, Dastjerdi R, Spiegelman D, Fawzi WW, Missmer SA, Lieberman E, et al. Kangaroo mother care and neonatal outcomes: A meta-analysis. Pediatrics. 2016;137:2015–238.
Soni A, Amin A, Patel DV, Fahey N, Shah N, Phatak AG, et al. The presence of physician champions improved Kangaroo mother care in rural Western India. Acta Paediatr. 2016;105:e390–5.
Jayaraman D, Mukhopadhyay K, Bhalla AK, Dhaliwal LK. Randomized controlled trial on effect of intermittent early versus late Kangaroo mother care on human milk feeding in low-birth-weight neonates. J Hum Lact. 2017; 890334416685072.
Seidman G, Unnikrishnan S, Kenny E, Myslinski S, Cairns-Smith S, Mulligan B, et al. Barriers and enablers of Kangaroo mother care practice: A systematic review. PLOS One. 2015;10:e0125643.
Bergh A-M, Kerber K, Abwao S, Johnson J de-Graft, Aliganyira P, Davy K, et al. Implementing facility-based Kangaroo mother care services: Lessons from a multicountry study in Africa. BMC Health Serv Res. 2014;14:1.
Kirigia JM, Nganda BM, Mwikisa CN, Cardoso B. Effects of global financial crisis on funding for health development in nineteen countries of the WHO African Region. BMC Int Health Hum Rights. 2011;11:1.
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Joshi, M., Sahoo, T., Thukral, A. et al. Improving Duration of Kangaroo Mother Care in a Tertiary-care Neonatal Unit : A Quality Improvement Initiative. Indian Pediatr 55, 744–747 (2018). https://doi.org/10.1007/s13312-018-1372-7
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DOI: https://doi.org/10.1007/s13312-018-1372-7