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

Henderson, Shakira

Background:

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.

Purpose:

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

Results:

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 95^thpercentile.

Conclusion:

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.