A Quality Improvement Initiative to Increase Skin-to-Skin Care and Positive Parent Touch

Positive parent touch (PPT), including skin-to-skin care (STSC) and containment, is an evidence-based practice that provides short- and long-term benefits to preterm infants, while also improving parent-infant attachment and reducing parental stress. This quality improvement (QI) initiative aimed to decrease average days from birth to first STSC in infants born less than 29 weeks' gestation from 14.2 days to 7 days. A secondary aim was to decrease the average number of hours from birth to first PPT in the same population from 41.3 hours to ≤24 hours. Data were stratified by ethnicity to identify disparities. Using the Model for Improvement, a multidisciplinary team collaborated to identify barriers to early STSC implementing strategic interventions to improve STSC and PPT. Data were monitored and analyzed using statistical process control and run charts. An improvement was noted in mean days for STSC from a baseline of 14.2-3.3 days. Similarly, an improvement was noted in mean hours for PPT from a baseline of 41.3 hours to 28 hours. This NICU improved and sustained time to first STSC and PPT in preterm infants by combining QI methods with a family-centered care approach that emphasized neuroprotection and parent involvement.