Barriers to Implementation of Skin-to-Skin Care

Abstract

<h2>Poster Presentation</h2><h3>Objective</h3> To determine the perceptions of perinatal nurses of barriers to implementation of skin-to-skin care (SSC) in the acute care setting. <h3>Design</h3> Quantitative, descriptive, correlational study. <h3>Setting</h3> Two Northern California hospitals that have committed to breastfeeding and SSC with similar delivery rates and geographical location, but different Baby-Friendly certification status. <h3>Sample</h3> The sample consisted of 76 labor and delivery and neonatal intensive care unit registered nurses from the two medical centers. <h3>Methods</h3> Nurses were anonymously surveyed using a 20-question Likert-style survey developed by the researcher. The survey's reliability was established by performing a pilot study of ten perinatal nurses. Cronbach's alpha reliability coefficient was applied with a result of a .76 reliability coefficient, indicating that the survey would reflect fine discriminations in the levels of the construct. The Mann-Whitney <i>U</i> test was applied to the sample with further calculations of <i>z</i> and <i>p</i> values to determine significance of responses. <h3>Results</h3> Using standard values to reject the null hypothesis, calculations revealed that 15 of the 17 nondemographic questions demonstrated a more favorable response to the implementation of SSC per Baby-Friendly standard from nurses employed at the Baby-Friendly certified facility. <h3>Conclusion/Implications for Nursing Practice</h3> As hospitals make a commitment to assist mothers with successful breast feeding, additional research is needed to examine the effect of nursing culture on this goal. We examined hospital practices, procedures, and routines that affect SSC and ultimately the question <i>Does having a Baby-Friendly Hospital Certification affect the nursing culture on the perinatal unit</i>? Our results hold implications for facilities attempting to implement SSC and change practice from task-oriented to evidenced-based nursing care. By first evaluating the nursing culture, educators can implement training specific to the needs of the group they serve. Any successful attempt to promote evidence-based practice must consider research that addresses barriers and facilitators to the adoption of the practice by nurses. Therefore, identifying barriers should be considered a primary step in implementing evidence-based practice changes.