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Facilitating Skin-To-Skin Contact

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The article “Facilitating Skin-to-Skin Contact in the Operating Room after Cesarean Birth” was written by Susan Stone, Lyn Prater, and Rebecca Spencer. The purpose of this project was to implement an evidence-based change to provide skin-to-skin contact (SSC) in nonemergent, full-term cesarean births in low-risk healthy mothers and neonates. The three main goals of this project were to develop a protocol for health care professionals’ roles in providing SSC in the OR, implement the protocol, and evaluate the process of implementation of the evidence-based intervention. The project was conducted at an inner-city hospital in the Southwestern United States. The Iowa Model of evidence-based practice to promote quality care and Lewin’s Change …show more content…
A significant limitation was obtaining support from the neonatology team on the practice of SSC after birth. NICU nurses were also expected to attend all cesarean births to determine neonatal stability. However, the NICU nurses felt there wasn’t adequate staffing to remain in the OR to accommodate skin-to-skin practice. This presented a significant issue because skin-to-skin contact in the OR cannot happen without a nurse present in the OR with the sole responsibility of monitoring the newborn. The data collection process also led to challenges in the project as it proved more time consuming than originally planned due to the project manager not being present during the data collection …show more content…
Though skin-to-skin contact immediately following cesarean birth is encouraged, the team determined that the safest newborn practice was to continue the surgeon’s routine of passing the newborn to the NICU nurse or NAN to be initially stabilized and assessed under the warmer. Apgar scores, stimulating and warming, and obtaining the newborn’s weight was completed during this time under the warmer. The newborn was then brought to the mother for skin-to-skin contact for five minutes if deemed stable. Data found that most participants either agreed or strongly agreed on the ease of use of the protocol. The open-ended questions provided staff members the opportunity to comment on their level of comfort and support of the protocol and most participants provided positive responses, “went smoothly and did not interfere with my job” and “I’m glad we are implementing this.” At the completion of the project, the following suggestions were made: providing a chair specifically for the NAN to use at the woman’s head, making sure that a stethoscope, thermometer and glucometer necessary for newborn care were easily accessible, ensuring the recovery room nurse would continue skin-to-skin in the recovery room, and addressing communication issues so obstetricians and anesthesia personnel would understand that skin-to-skin would be expected in

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