63 - Increasing Skin to Skin Contact in Labor Room to Improve Breastfeeding Rates After Delivery: A Quality Improvement Project

Poster Number: 63
Publication Number: 63.2722

Background: Skin-to-skin contact (SSC) in the first hour of life points to higher rates of breastfeeding and associated physiologic, social, and psychological benefits for both the mother and baby. For example, SSC helps with thermoregulation and cardiorespiratory stability for the neonate. As for the mother, it can decrease maternal stress.

Objective: On January 2022, the percentage of SSC at University District Hospital’s (UDH) labor room in Puerto Rico was less than 26%. Our objective was to identify current obstacles and implement quality improvement (QI) initiatives to achieve an increase in SSC in the first hour of life. Our goal was to increase skin-to-skin contact during the first hour of life from 26% to at least 50% by December 2022 in eligible newborns.

Design/Methods: First, a need assessment was performed, and the baseline data of SSC in the first hour after birth in the UDH labor room was collected. Following this, root analysis tools were employed (fishbone diagram, analysis flow diagram) to identify contributing factors that delayed initiation of SSC. Multiple interventions were executed, including; nurse staff and parent education, anesthesia team orientation, and resident knowledge. Interventions were periodically scheduled throughout the year. Subsequently, we utilized the Plan, Do, Study and Act (PDSA) methodology to assess the impact of these interventions. SSC percentage was monitored from January 2022 to June 2023, including births of neonates born at 35 weeks of gestational age (WGA) or greater with first Apgar score ≥ 7. Using a standard run chart, we plotted SSC percentage per month and compared it to baseline and to our goal of 50% of SSC.

Results: During the need assessment, baseline data was collected and found with approximately 26% of SSC in the first hour. After interventions were implemented, SSC rose over 50%. This increase has been sustained during the last 9 months, with peaks in SCC up to 85%.

Conclusion(s): Implementation of quality improvement methodologies are essential tools to overcome challenges in proposed improvements. In this case, an increase in skin-to-skin contact rates in hospitals and, therefore, breastfeeding. If issues that may be barriers to their occurrence are properly identified from a system wide analysis perspective, the end goal will be systematically achievable.