Implementation and Evaluation of Transitioning Newborns at the Bedside Maternal-Child Leadership Project

Saturday, 7 November 2015

Sonya L. Clayton, MSN, RN, IBCLC, CCE
Perinatal Unit, West Kendall Baptist Hospital, Miami, FL, USA
Shakira Henderson, DNP, MS, MPH, RNC-NIC, IBCLC
Research, Vidant Health, Greenville, NC, USA
Katheryn B. Arterberry, DNP, MSN, RN, APRN, FNP-BC
College of Nursing and Allied Health, Northwestern State University of Louisiana, Shreveport, LA, USA


Traditionally, mothers and babies are separated after birth. However, strong evidence exists that immediate skin-to-skin contact after birth between mother and baby has positive outcomes for both mother and baby. Babies who transition with their mothers have better breastfeeding rates and mothers who transition with their babies are more satisfied with the birthing process. Nonetheless, nurses are challenged daily with promoting skin-to-skin, especially after a cesarean delivery. West Kendall Baptist Hospital embarked on a journey to implement a change process of transitioning all eligible newborns at the bedside.  The project was facilitated through the STTI Maternal-Child Health Leadership Academy.


To implement and evaluate a Bedside Newborn Transition Initiative emphasizing Skin-to-Skin after Birth Maternal-Child Leadership Project

Specific Aims

  • To utilize leadership strategies to implement Bedside Newborn Transition emphasizing Skin-to-Skin after Birth Maternal-Child Leadership Project
    • To train all Labor and Delivery nurses to transition newborns at the bedside
    • To transition all eligible newborns at the bedside
    • To decrease separation time of couplets ( i.e. the mother/baby dyad)
    • To increase skin-to-skin initiation rates
    • To maintain patient satisfaction scores at or above 95%
    • To increase exclusive breastfeeding rates

Project Activities

  • A unit-specific taskforce made of key stakeholders was developed and lead by the STTI Maternal-Child Leadership Academy Fellow.
  • The taskforce over a 6-month period:
    • Met monthly
    • Completed training for all Labor and Delivery nurses on transitioning at the bedside
    • Performed patient chart audits to monitor skin-to skin initiation rates, breastfeeding exclusivity rates, and separation times
    • Tracked Satisfaction surveys of transitioning mothers

Evaluation Methods

  • Staff Education Training data
  • Monthly tracking of skin-to-skin initiation of all eligible newborns data
  • Monthly tracking of transitions of all eligible newborns data
  • Monthly Press Ganey patient satisfaction survey results
  • Monthly tracking of exclusive breastfeeding rates


Twenty-six Labor and Delivery nurses were trained and 338 patients were cared for during the 6-month period.  The number of infants transitioned at the bedside increased by 70%. The separation time of couplets decreased by 90%. The skin-to-skin initiation rates increased by 75%.  Exclusive breastfeeding rates increased by 55%. Mother satisfaction with bedside transition remained at the 95thpercentile.


Transitioning newborns at the bedside has a positive impact on skin-to-skin initiation rates, patient satisfaction, and exclusive breastfeeding rates. Skin-to-Skin after Birth Maternal-Child Leadership Project may be a promising approach to accomplishing newborn bedside transitioning.