Guest Editorial: Delivery Room Issues

Abstract

A s neonatal and infant nurses, we spend most of our professional lives in the neonatal intensive care unit and nursery. Because of this, we can sometimes forget how important and impactful our practice in the delivery room (DR) can be. For most United States born infants, the first glimpse of this big, exciting world is the inside of a DR or operating room (OR). As neonatal nurses, we enter the DR and OR at a time of mixed emotions: excitement and joy over the birth of a new being, concern and fear over its health and survival. This issue of Newborn and Infant Nursing Reviews delves into this critically important period and addresses a variety of concerns. Before a newborn emerges and becomes our patient, the mother's womb is its caretaker. In our first article, Baker reviews the impact of thermal interventions in the operating room for mothers and resulting neonatal outcomes. For this study, Baker conducted a retrospective chart review of mothers who underwent a scheduled low-risk cesarean delivery with the use of epidural or spinal anesthesia. She provides a compelling argument for the importance of maintaining an adequate thermal environment and proposes further investigation into the use of skin-to-skin practices in the OR. Sticking with the concept of hypothermia, our second article, by Cordaro et al, looks at the evidence for occlusive skin wrap use in the low-birth-weight premature infant population. This review provides a historical look at how the idea of a skin wrap progressed and where we are today. Also included is an excellent evidence-based guideline for the use of occlusive skin wraps that any institution can use to help craft or update their protocols. Evidence-based protocols are part of the cornerstones that help create an environment of clinical excellence. In our third article, Wallingford et al share their experience with implementing a quality improvement project focused on adopting “golden hour” practices. Upon realization that their practices in the DR greatly varied from one care provider to another, this team adopted standardized processes targeted to reduce the incidence of chronic lung disease in infants born at less than 33 weeks. Their success in decreasing chronic lung disease is a testament to their dedication to continuous quality improve-