IMPROVING KANGAROO MOTHER CARE HOURS IN THE NEONATOLOGY DEPARTMENT: A QUALITY IMPROVEMENT INITIATIVE

Abstract

Aim: To assess barriers to initiating and sustaining Kangaroo Mother Care (KMC) in the neonatology department and implement a Quality Improvement (QI) initiative to increase KMC hours for neonates weighing less than 2500g and below 37 weeks of gestation.

Methods: This quasi-experimental study was conducted at Saveetha Medical College neonatology department. All neonates under 37 weeks and under 2500gm born between January 2024 and September 2024 and those under 2500g delivered between January 2023 and December 2023 were included. The baseline KMC duration was assessed over one year. A QI team, including doctors and nurses, used fishbone analysis to identify barriers and categorised them under policy, people, procedure, and place. Interventions were implemented through four Plan-Do-Study-Act (PDSA) cycles, each lasting three weeks, followed by six weeks of monitoring. Strategies included nurse education, patient counselling, and involving family members in care. Outcomes were measured by the increase in average KMC hours.

Results: At the start, the average KMC duration was 8 hours/day for eligible neonates. After four PDSA cycles, which included staff education and family involvement, the average KMC duration increased to 10.4 hours/day. The QI initiative led to a successful and sustainable increase in KMC hours, and KMC was integrated into routine NICU practice.

Conclusion: The QI initiative significantly improved KMC hours by addressing department -specific barriers. This approach is a simple, effective way to enhance neonatal care practices. Future projects will focus on immediate KMC implementation and its impact on growth and mortality.