Quality of Care Strategies and the Subsequent Improvement of Kangaroo Care Incidence Rates in Premature Infants

Purpose: The benefits of kangaroo care (KC) has long been studied and proven. Despite the research, incidence rates of KC are low in the neonatal ICU at the Kentucky Children’s Hospital. Some barriers to KC exist in our NICU and this study strives to address them. This study aims to develop and implement strategies to increase utilization of KC from 41% to 75% for eligible infants. Methods: KC occurrence was monitored in 364 infants with birth weight ≤ 1250 grams. Strategies implemented were education of nurses, improved nurse-to-patient ratio, emphasis of KC in multidisciplinary rounding, improved documentation, obtaining securement devices to prevent dislodgement of invasive lines, involvement of respiratory therapists in transferring intubated infants, and providing pamphlets and one-on-one education to patents. Weekly KC occurrence was reviewed on all NICU infants with birth weight ≤ 1250 grams. Results: KC utilization was analyzed in two separate periods- August through December 2016 and January through May 2017. The mean utilization for the 2016 period was 41% and the mean utilization for the 2017 period was 61%. This reflects a 20% increase in occurrence following the measures implemented to improve KC rates (p=0.02, t-test for independent variables). Conclusion: Increased use of KC occurred due to implementation of a variety of measures. These measures and results indicate that establishing kangaroo care as a standard of care in very low birth weight infants is obtainable. Audits will continue being collected each month to verify a continued increase