Implementation of Delayed Cord Clamping in Vigorous Preterm Neonates

Abstract

ObjectiveTo adopt evidence-based recommendations to delay cord clamping in vigorous preterm neonates. DesignEvidence-based practice change project with quantitative data. Setting/Local ProblemDelayed cord clamping (DCC) was not a usual practice at the hospital where this project took place, despite research findings that show benefits of DCC for preterm neonates. ParticipantsVigorous neonates born before 37 weeks completed gestation. Intervention/MeasurementAn interprofessional obstetric team of obstetricians and registered nurses implemented DCC for up to 1 minute for vigorous preterm neonates. ResultsWe found that Apgar scores at 1 minute (mean [M] = 8.35, standard deviation [SD] = .551, n = 31) were statistically significantly higher with DCC than at 1 minute with immediate cord clamping (M = 7.16, SD = 1.834, n = 19) at t (20.008) = 1.197, p = .012. The Apgar scores at 5 minutes (M = 9.00, SD = 0.258, n = 31) were statistically significantly higher with DCC than at 5 minutes with immediate cord clamping (M = 8.58, SD = .838, n = 19) at t (20.116) = 2.130, p = 0.046. ConclusionDelayed cord clamping was adopted as a usual clinical practice, and implementation of this practice in vigorous preterm neonates increased their Apgar scores. The obstetric team’s awareness, experience, and professional perspectives about DCC improved.