Increasing skin-to-skin care in very and extremely preterm infants using an iterative quality improvement approach

采用迭代式质量改进方法增加极早产儿和超早产儿的皮肤接触护理

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Abstract

OBJECTIVE: This quality improvement (QI) initiative aimed to increase skin-to-skin care (SSC) and positive parental touch (PPT) rates to >90 % among infants <32 weeks' gestation in a Level IV NICU. METHODS: Guided by a key driver diagram, interventions were implemented through three Plan-Do-Study-Act (PDSA) cycles: developmental rounds (month 1), parent education (month 6), and the Supporting and Enhancing NICU Sensory Experiences program (month 8). We evaluated PPT within 72 h of birth, SSC within the first week of life, and time to first SSC during the development, implementation, and sustainability phases. RESULTS: SSC rates increased from 71 % (development) to 93 % (implementation) and 94 % (sustainability). PPT rates sustained at 98 % during the implementation and sustainability phases. No increases in unplanned extubation or intraventricular hemorrhage were observed. CONCLUSION: A structured, multidisciplinary approach improved and sustained SSC rates for preterm infants without adverse effects.

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