MARGARET DEANSHANNON ARCHULETADANELLE SCHWEIGER

TIFFANY WARD

Mother Infant Recovery Family Centered Care

Promoting Early Breastfeeding & Skin to Skin Contact for Caesarean Deliveries at Walnut Creek

Kaiser.

2012 Hospital Goal

Exclusive breast milk feeding is a clearly established goal of the World Health Organization (WHO), American Academy of Pediatrics (AAP), the Department of Health and Human Services (DHHS), and the Centers for Disease Control and Prevention (CDC) and as of April, 2010, is a Joint Commission Perinatal Core Measure (Flaherman & Newman, 2011).

The goal is a rate of 70% exclusive breastfeeding upon discharge.

Educating Staff and Families

Benefits of skin to skin contact include:

Regulation of infants heart rate, respiratory rate, temperature, and glucose levels.

Elicits maternal hormones that aid in milk production.

Infants remain calmer and ready to breastfeed.

More likely to exclusively breastfeed at discharge.

The Natural Habitat

Skin to skin- Your skin the natural habitat where baby should transition and begin his own regulations of breathing, heart rate, temperature etc…

Our Mission

Establish a family centered approach for our cesarean section deliveries.

To keep mom’s and babies together throughout recovery.

Promote skin to skin in the operating room and continued bonding in our mother infant recovery area.

Allow for significant other to experience skin to skin contact if mother’s is unavailable.

Improve our skin to skin and exclusive breastfeeding results to 70% at discharge by the end of 2012.

Collaborative Team Effort

We involved members of our breastfeeding collaborative, NICU and well baby staff, L&D nurse’s, respiratory therapy, anesthesia, doctors, and midwives.

Our Process

The RN assigned to the infant in the OR (usually the ALS or NICU shift leader) initiate and document skin to skin in the operating room.

The infant is brought into our mother infant recovery area. The significant other accompanies the infant and the mother joins them there.

If the mother is unstable the significant other is given the opportunity to do skin to skin.

The infant spends the first hour of recovery skin to skin and supported with breastfeeding assistance.

The Transitional Care Center

We converted one gurney bay into our transitional care center. The infant is recovered next to it’s mother’s side.

The infant spends the first hour of recovery skin to skin and supported with breastfeeding assistance.

In the last 30 min the infant receives an assessment, vital signs, bath, and medications prior to the family moving to our mother baby unit.

Our Success

February 27, 2012, marked our first day of the mother & infant recovery post cesarean section. It was a giant step forward in recovering our moms and babies together. A huge thank you for all who worked on the process: Monina Jose, well baby nurse for the day, Natasha Pottish ALS, Deb Newson SL NICU, Mary Clancy NICU RN, Jody Knight, Jen Holthaus, Deb Wood L&D RN’s, Amy Bode CRNA, and Dr. Nan OB.

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Comments From Families

The patient was amazed at the experience stating, “I was only expecting him to be with me, skin to skin, not actually be nursing in recovery!”

Father was overheard telling family, "No, the baby is isn't in the nursery he's with us. They believe in keeping the families together here.“

Mother said, "Last time the baby went to the nursery and I was left here all alone. This is sooo much better having the baby with me!"

Summary

We used a tracking log to capture and review records for those patients who were recovered together.

We established a communication binder for constructive feedback and used this information to enhance the process.

We are currently looking to expand to evening and night shift unscheduled cesarean sections.

A moment in time, a world of difference.