211 - Kangaroo Care as a cultural norm in neonatal intensive care unit: A 7-Year Regional Quality Improvement Project

Poster Number: 211
Publication Number: 211.126

Maria Fe B. B. Villosis, Kaiser Permanente Southern California Medical Group, Panorama City, CA, United States; David Braun, Dept of Research and Evaluation, Southern California Permanente Medical Group, Santa Monica, CA, United States; Karine Barseghyan, Souther Permanente Medical Group, Panorama City, CA, United States; Elena Ornelas-Pelaez, Kaiser Permanente - Panorama City Medical Center, Panorama City, CA, United States; Heaven Holdbrooks, Kaiser Permanente Orange County, Huntington Beach, CA, United States; Ma. Teresa Ambat, Kaiser Permanente Bernard J. Tyson School of Medicine, Valley Glen, CA, United States; Rosa V. Chen, SCPMG, Claremont, CA, United States; Edgar Chernin, Kaiser Foundation Hospital Riverside Medical Center, Riverside, CA, United States; Hannaise C. Cruz, Kaiser Permanente West Los Angeles, Los Angeles, CA, United States; Bisrat Gebrekristos, Kaiser Permanente - Orange County, Anaheim, CA, United States; Mandhir Gupta, Kaiser Permanente Pediatric Care Center Downey, Downey, CA, United States; Arash Moghimi, Kaiser Permanente Pediatric Care Center, los angeles, CA, United States; Rohit Passi, Kaiser Permanente South Bay Medical Center, Harbor City, CA, United States; Aaron J. Reitman, KAISER PERMANENTE BERNARD J. TYSON SCHOOL OF MEDICINE, Beverly Hills, CA, United States; Carl E. Shangle, Kaiser Permanente Pediatric Care Center, San Diego, CA, United States; Huy Truong, Kaiser Permanente, Fontana, CA, United States; James A. Washington, Kaiser Permanente Southern California, Rancho Cucamonga, CA, United States; Marianna Volodarskiy, Kaiser Foundation - Pasadena, Pasadena, CA, United States; Quinn L. Hong, Kaiser Permanente, West Covina, CA, United States; Marielle Nguyen, Southern California Permanente Medicine, Anaheim, CA, United States

Background: Kangaroo care (KC) or skin-to-skin contact (SSC) is an evidence-based intervention that hasbeen shown in numerous studies to improve neonatal outcomes. Its adoption as a standard ofcare in the NICU has been underutilized.

Objective: 1) To evaluate the outcome of the implementation of KC in SCAL NICUs over 7 years.2) To increase the patient days exposed to kangaroo care among patient days in the NICU when aparent is present.

Design/Methods: This quality improvement study included all NICU patients admitted to 13 NICUs with 5 surgical,4 Level III, and 4 level II in Kaiser Permanente Southern California from 2015 through 2021.The study period was divided into 2 periods: Pre-intervention of Plan-Do-Study-Act (Jan. 2015-June 2018) and Post-intervention of Plan-Do-Study-Act (July 2018-Dec. 2021).The KC was implemented through a multi-disciplinary team-based approach by surveillance,engagement, teamwork, collaboration, communication, target setting, team reinforcement,education, and documentation. Data was collected from a structured data element in theelectronic medical record used for the nursing charting of KC on a monthly basis.

Results: The implementation of KC resulted in a sustained increase of skin-to-skin associated NICU daysfrom a baseline of 40% in 2015 to 67% in 2021. Special cause variation was observed betweenpre-intervention and post-intervention. The surgical NICUs increased by 67% (37% in 2015 to62% in 2021), Level III NICUs increased by 62% (45% in 2015 to 73% in 2021), and Level IINICUs by 58% (48% in 2015 to 76% in 2021).Conclusion(s): The KC implementation through a multi-disciplinary team-based approach led to sustainedadoption and increased rates in our NICUs.
SCAL Kangaroo Care QI Project Years 2015-2021% of NICU Patient Days when Parents are Present with One or More Skin to Skin events
P-Chart KC Pre-Intervention Jan 2015-June 2018 and Intervention July 2018-Dec. 2021Chance of Skin to Skin Event on Days Mothers Present / All KPSC NICU Days