Improving initiation of kangaroo mother care in a tertiary care hospital – A quality improvement initiative

Abstract

Background: Kangaroo mother care (KMC) is shown to be effective for thermal control, breastfeeding and bonding in all newborn infants, irrespective of setting, weight, gestational age, and clinical conditions. Objective: The objective of this study was to increase the percentage of initiation of KMC in stable low birth weight babies (<2000 g) admitted in special newborn care unit through a quality improvement (QI) approach in a tertiary care neonatal unit. Materials and Methods: Preterm mother-infant dyads who were admitted in the inborn Level 2 neonatal intensive care unit were enrolled in this study. The potential barriers for prolonged KMC were evaluated using fishbone analysis. A variety of measures (improving knowledge, attitude, and practices on KMC among health-care staff and mothers and other family members, information, education, and communication material on KMC in KMCroom, one-to-one structured counseling of mothers, modifying KMC registers, etc.) were introduced and subsequently tested by multiple Plan-Do-Study-Act cycles. Data on percentage of initiation of KMC were measured by bedside nurses on daily basis in each shift. Results: A total of 81 eligible mother-infant dyads were studied during implementation period (50 days). The mean weight and gestation of infants were 1364.9 g and 31.9 weeks, respectively. The percentage of initiation of KMC among eligible preterm infants has increased from a baseline of 16%–94.8% over a period of 8 weeks. Conclusion: Ongoing QI measures increased the percentage of initiation of KMC among eligible preterm infants from baseline of 16%–94.8% over a period of 8 weeks.