Increasing Rate of Skin-To-Skin Contact in Labor Room under Golden Hour: A Quality Improvement Project

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Write it completely down to the methodology, do not write the results or the discussion

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Title:

“Enhancing Skin-to-Skin Contact in the Labor Room: Strategies and Outcomes of a Quality Improvement Project at UDH”

Abstract:

Summarize the goal of the QI project (to increase SSC rates), the methods used (like staff education, protocol changes), key findings (increased SSC rates, improved compliance), and the implications for practice (highlight the importance of SSC in neonatal and maternal care).

Introduction:

• Background: Discuss the importance and benefits of SSC immediately after birth for both newborns and mothers.
• Problem Statement: Describe the existing challenges in implementing SSC consistently, especially in specific contexts like C-section deliveries.
• Project Aim: Clearly articulate the aim of increasing SSC rates in the labor room at UDH.
• Significance: Explain the expected benefits of successful SSC implementation for neonatal care, maternal bonding, and overall healthcare quality.

Literature Review:

• Benefits of SSC: Review research supporting the physiological and psychological advantages of SSC.
• Barriers to SSC Implementation: Discuss challenges identified in literature, such as logistical issues, staff resistance, or lack of awareness.
• Strategies for Enhancing SSC Practice: Examine studies or projects that successfully improved SSC rates and the strategies they employed.
• Gaps in Practice: Identify where your project fits into the current body of knowledge and what gaps it addresses.

Methods:

• Project Setting and Participants:
  The QI project was implemented at University District Hospital (UDH), which serves a diverse population. The project focused on all labor and delivery room staff, including physicians, midwives, nurses, and anesthetists, as well as mothers who delivered at UDH and their newborns without contraindications to breastfeeding.

  Quality Improvement Framework:
  Our project utilized the Plan-Do-Study-Act (PDSA) cycles within the context of the Institute for Healthcare Improvement (IHI) Model for Improvement. The primary aim was to increase the percentage of eligible newborns experiencing SSC in the first hour of life from 26% to 50% by December 2023.

  Root Cause Analysis:
  A multidisciplinary team conducted a root cause analysis using the Fishbone diagram to identify factors contributing to delayed initiation of SSC. Two main issues were identified: the logistical challenges of SSC in cesarean deliveries and excessive personnel intervention immediately after birth.

  Key Driver Diagram:
  We developed a key driver diagram to visualize our strategy, focusing on specific interventions that addressed our identified root causes. The key drivers included staff education, anesthesia team cooperation, minimizing unnecessary interventions post-delivery, and parent education.

  Interventions:
  The intervention phase involved multiple actions:

  1. Nurse Staff Education: A series of educational sessions were conducted to train nursing staff on the importance of SSC and techniques for facilitating SSC immediately after birth, including cesarean sections.

  2. Anesthesia Team Orientation: Anesthetists were oriented on new protocols to accommodate SSC during cesarean procedures, ensuring mother and infant safety while promoting early contact.

  3. Parent Educational Brochures: Informative brochures were created and distributed to expectant parents to raise awareness about the benefits of SSC and to empower them to request this practice.

  4. Protocol Adjustments: The labor and delivery protocols were revised to prioritize SSC unless contraindicated. This included the delay of non-urgent procedures to allow for uninterrupted SSC.