European Journal of Cardiovascular Medicine

Background: Improvement of number of low birth weight (LBW) baby-mother dyad practicing KMC in postnatal ward in a tertiary care hospital of eastern India and to increase number of babies weighing between 1.8-2.5kg receiving KMC from 11.5% to at least 60% in postnatal ward with increment of total duration from 1.9 to minimum 8hours a day. Methods: QI team was formed. The potential barriers for initiation of KMC among this group of dyads were evaluated using fish bone analysis. Stepwise measures (initiation of early skin-to-skin contact immediately after birth), KMC as an integral part of treatment, counseling of mothers, allotting dedicated nursing staff in each shift to monitor KMC, introduction of bedside KMC Sheet with KMC register, provision of separate beds for “KMC corner”) were introduced and subsequently tested by multiple Plan-do-study-act (PDSA) cycles. Data on duration of KMC per day was measured by bedside nurses on daily basis. Results: Total 510 neonates were enrolled in the study (110 in baseline phase, 116 in implementation phase and 293 in post intervention phase). Demographic characteristics including birth weight and gestational age were comparable among baseline and post intervention cohorts. During implementation phase, KMC of any duration was received by 40.5%, 67%, 82.5% and 95% neonates following PDSA I, PDSA 2, PDSA 3 and PDSA 4, respectively against 11.5% of baseline phase. In comparison to baseline phase, mean duration of KMC increased from 1.9 hours to 8.6 hours during post implementation phase. Conclusions: Stepwise implementation of PDSA cycles significantly increased the percentage of LBW newborns of weight 1.8-2.5kg receiving KMC for >6 hours a day in Postnatal Ward, thereby resulting in earlier discharge.