Implementation Updated: 5/29/10 & 2/12/2014 When it comes to implementation, the people in the setting are the experts because implementation is setting specific, so acknowledge their expertise and be flexible.

______2014 Neon Netw PT, survey of 129 NICU nurses beliefs about almostcontinous SSC and how those beliefs and barriers should be considered to improve implementation ______(2004). PT. Holding the very low birthweight infant: skin-to-skin techniques. Neonatal Network. Article describes the nursing considerations and techniques involved to successfully implement skin-to-skin holding for VLBW, technology dependent infants. Aguilar Cordero et al. 2012 PT, descriptive, Palestine. 252 moms of preterms who were told about KC did more KC. Younger mothers did more KC than older mothers. Atchan, 2013 FT, BFHI is not working in Australia (only 19% certified in 2013) because birth KC is “a discord with practice” Barros et al. 2010 PT, This is one of a series of articles talking about implementing key interventions to reduce mortality and morbidity in preterm infants. Barros reviews the literature and says that KMC is a key intervention. See also the Victora et al. 2010 article and the list of all articles in the series for PUBLIC HEALTH level scale up of KMC. Scale up means achieving universal coverage of KMC for all members of the community. Beal et al.,2005 Review of best practices for neonate that need to be implemented and has suggestions of how to do this. Bell, Geyer, Jones, 1995 Bell, McGrath, 1996 PT Lack of consistency in implementing KC is major factor For lack of KC use. Wanted KC to be standard of care. They developed a policy and implementation procedure

Bergh & Pattinson, 2003

Bergh et al., 2005 Reports 8 steps of implementation and bench marks for each phase of implementing KC on routine basis. Bergh et al., 2008 No difference in implementation of KC (score>10) between hospitals with on site and those with off site education Bergh et al., 2012 PT, 10 hospitals were scored on her implementation scoring system for use of 24/7 KMC for preterms in Indonesia. Implementation takes years and dedication and support for years. Bergman & Bergman 2013 FT, relates implementation of KC as a KANGAROULA for doulas and the things that they should be doing and teaching to their clients. Blomqvist et al. 2012 PT, qual and quantitative study of Parentally perceived supports and barriers to KC in NICU- staff were both, feedings, and comfortable position were barriers to 24/7 KMC. Bramson, et al., 2010 FT, descriptive of 21,842 moms who got KC in first 3 hours post-birth. The more kc they got the more likely they were to exclusively BF. But not really about implementation, just result of implementation. Byaruhanga et al. 2008 FT, qualitative to help learn mom’s perceptions about KC to facilitate implementation of KC – has good references for evidence based not yielding practice and policy changes. Calais et al.,2010 FT, comparison of Swedish and Norway KC in postpartum period. Need antenatal education, reduced visitors, and support for effective postpartum implementation. Cantrill et al, 2004 FT, has tool measuring RNs knowledge of KC in relationship to Birth KC and breastfeeding. Knowledge is first step to implementation. CDC 2005 FT, national recommendation on page 1 to use KC after birth to support breastfeeding CDCP 2007 FT, national survey of 3 birth KC practices to support breastfeeding Cesarotti, 2012 PT, mother’s recounting of having to “push the boundaries and asked to do KC, sometimes twice a day- for her preterm infant. Chia et al., 2006 PT, nurses’ attitudes and practices toward NICU KC. Colameo & Rea, 2006 PT, review of implementation process in Brazil. Davanzo et al. 2013 PT, a sample NICU policy is needed to improve use of KMC in NICUS and they wrote one based on INK recommendations and include it. Davis et al.,2012-2013 FT, Quality improvement project telling how they taught everyone in 2 hours to improve their exclusive BF rate. Has test questions and benefits of exclusive BF in article and process followed De Aranjo et al. 2010 PT, evaluation of KMC at home in Brazil (46.7% moms do 5-6 hrs KC/day Declercq et al., 2009 FT, survey of mothers to learn what helped them EXCLUSIVELY BF and the first thing was birth KC to initiate feedings and three others were no supplements., no pacifiers, and nursing support. DeLeeuw 1989 PT, report of years of routine KC that promoted parental-infant bonding without harming infants at all De Hollanda Parisi et al., 2008 PT, Qualitative study of 5 nurses perceptions of implementing KMC in NICU in Brazil. Nurses must be involved and human and physical resources need to be adequate. DiMenna 2006 PT. Presents evidence based guidelines for KC in the neonatal unit and talks about things needed to do KC well, like knowledge, education, and written guidelines. De Vonderweid 2009 PT Survey of developmental care practices in all Italian NICUs and KMC is implemented in 67% of them. Eichel, 2001 Relates steps to starting KC with vented babies Engler et al., 2002 PT, national review of attitudes, barriers, and Presence of implementation guidelines to NICU KC. Lack Of consistent guidelines contributes to most barriers to KC Use. Education is CRITICAL for implementation of KC Engmann et al., 2013 PT,FT, Acceleration of the Implementation of KC is ABSOLUTELY CRITICAL AND NECESSARY Field et al., 2006 FT, surveyed 25 NICUS in the south. KC following birth In the delivery rooms occurs in 83% of the hospitals. Filho et al. 2008 PT, Clin eval of 8 stepdown NICUs with KC and 8 without. Better exclusive BF in the 8 KC units. No other differences. Fischer et al. 1997 PT, review of how they have implemented KC in Heidelberg Franck, Bernal,Gale 2002 PT. Review of some NICUs related to having guidelines For NICU KC and how implementation is going Gontijo et al., 2010 PT, implementation in Brazil of 3 stages of KMC. Only stage one was done well, not the others (KMC ward and then discharge in KMC) Gontijo et al. 2012 PT, evaluation of KC implementation in Brazil by administrators showed need for periodic training and resource/space allocation. Guimaraes/Monticelli, 2007 PT, implementation of KMC in Brazil in level III NICU. Talks about three steps (recognize problem, read literature, and then NICU staff had to realign their ideas because some moms don’t want to do KMC to promote bonding. Gupta et al. 2007 PT, 50 infants give 4-6 hrs/day once stable til discharge. Good weight gain and short length of stay. All moms were breastfeeding too. Hardy, 2011 PT, Review of Dev. Care Chapter and she says implementation is behind and KC should be routinely implemented immediately. Haxton et al. 2012 FT, quality improvement project to implement Birth KC for BF Henderson 2011 FT, review of breastcrawl events and says that breast crawl can be implemented by nurses if Hospitals promote the breast crawl by educating nurses, get help gaining experience, adequate staffing, encouragement from management. Hendricks-Munoz et al 2013 PT, 61% of Black mothers NOT told about KC vs 39% of white mothers and foreign born nurses implement KC more than US born nurses. Hendricks-Munoz et al., 2010 PT, nurses need support to use KMC as developmental care option Hunt 2008 Lists barriers, facilitators for implementation of KC Johnson 2007 Having nursing and administrative support for KC and Sufficient staff is needed to implement KC. Talks about Things needed to implement KC Johnson et al., 2004 PT. identifies KC as an optimal family centered practice that single bedded NICU rooms will facilitate so KC Should be implemented. Kirsten et al., 2001 PT, talks about how to implement KC for preterm infants Kledzik 2005 PT addresses the barriers to using KC with PT and gives solutions for implementation Lamp & Zadvinski 2009 FT. Used IOWA model for implementation of evidence-based guidelines into Birth KC practice for full term infants. Has chart of implementation flow sheet.

Laudert et al.., 2007 PT, KC is one of 16 developmental care strategies designed to improve neurodevelopment in NICU infants due to exposure to maternal scent, provision of tactile stimulation, and preservation of sleep. Implementation must follow education and be center specific. Lazarov 1994 FT, talks to barriers and guidelines for implementing very Early KC for vaginal and cesarean delivery newborns Lee et al., 2011 PT, gave suggestions for dealing with barriers (defining clinically stable infant, nursing documentation, nursing education and motiviation, time it takes to help moms and getting moms to visit more and be comfortable) Magri et al. 2013 FT, quality improvement with PDSA cycles to increase EXCLUSIVE BF, One big barrier was birth kC but all staff were taught, mothers are taught upon admission, and 90% of moms now get Birth KC and all ten steps and EXCLUSIVITY rose from 6& to 44 & in 24 months. Mallet et al., 2007 PT, Descriptive study of knowledge, barriers, advantages of KC as known by French NICU staff. They all need knowledge, only knew one advantage (attachment), and had many fears of problems for babies that impacted on use of KC. McCain, G. 2003 PT In references to KC section. Evidence base is there for KC To improve BF outcomes, so teach RNs, write guidelines, And do it. Miller-Petrie, 2012 Report of 1st international Caribbean and Latin American KMC conference to implement and sustain implementation of KMC in these countries. Miranda-Wood, 2010 FT, relates Quality improvement project to implement SOFT to increase attachment and improve BF. Says this eradicated barriers. Mullen et al., 2007 PT, Review of hospital’s move toward more family centered care and says that in the NICU it does new developmental strategies, including KC, but implementation of non-separation of mom and full term infant means infant transitions at the mother’s bedside. Myers & Rubarth, 2013 PT 24-37 wk GA, description of maternal and nurses perceptions of facilitators and barriers to BF in the NICU. KC is a facilitator Nahidi et al., 2014 FT. developed tool to measure use of Birth KC Nelson, 2010 FT, Many verbal barriers to KC, developed coaches, gave education, collected success stories. Relates that poster provides success stories. Nyqvist, 2004 PT, includes policy used in Uppsala and has two approaches: #1 is educate about + effects of KC, #2 is Develop mutually agreed to policy. Olsson et al., 2012 PT, descriptive study of perceived attitudes and barriers to NICU KMC. Barriers are Heavy workload, insufficient staff education, insufficient staff experience, lack of organizational support, absence of clear protocols and professional performance expectations, safety issues in the infant, and resistance from health care professionals are barriers to KMC.

Pattrick et al., ??? PT, RCT, using tele-communication to improve implementation of KMC. Pattinson et al., 2005 PT, RCT, educational package with three visits by a faciliator improved implementation of KMC and implementation was higher in that group than educational package alone group. See also Patrick study. Pineda et al., 2009 PT, implementation of better BF behaviors after teaching nurses about BF that included KC as a pre-feeding intervention & to just keep using it to assist with BF in general. Price & Johnson, 2005 FT, implementation of Birth KC using Action Research approach. Birth KC went from 0-80% in 18 months. Lots of good helpful hints on reminders (stamps in chart, pics on wall, evaluation sheet, information sheet, table of benefits in each room, 8 pictures of the process in each room, etc.) Priya 2004 PT. Implementation evaluation of KMC with LBW. Quasem et al., 2003 PT/FT. Simple criteria for community based KMC Reeg & Lott, 2012 FT, Quality improvement project for implementing Birth Kc and gave lots of suggestions how to support this action. Renfrew et al.,2010 PT. Review. identifies barriers to breastfeeding PT hospitalized infants Renfrew et al., 2001 FT Review. Identifies barriers to bf a full term infant. Sandin-Bojo et al. 2007 FT, this one of the series reports the quality improvement project outcomes to increase implementation of all WHO 1996 recommendations of which Birth KC was one. Sandin-Bojo et al 2004,2006 FT, all are about studies of implementing WHO 1996 recommendations 2007, 2008, 2011 Schoch et al. 2014 FT, Quality improvement to become Baby Friendly; put 5 stations together and one was common challenges, another how to do skin to skin contact. 250 nurses processed and it was successful.

Scochi et al., 2003 PT, clinical report of what works well in Brazil. Senarath et al., 2007 FT, RCT of implementation of WHO’s Essential Newborn Care components. Training increased BirthKC by 1.5 times baseline. Smith, 2007 PT, implementation of KC to promote sleep and growth of Level III NICU infants. Restful sleep was discriminated from restless sleep, nurses needed sleep education Smith et al., 2008 FT, procedure for birth KC with cesarean birth described and all impediments (temperature of OR, anesthesiologists concerns, surgeon concerns and staff reluctance to give up OR rituals are discussed. Smith et al. 2012 FT. quality improvement project to implement Birth KC for BFHI Stening et al., 2000 PT, Review of practices in German NICUS (see also Theilig, 2003) Stevens et al.,2014 FT, review of KC with C/S studies and lists barriers to implementation of this practice, not to mention that WHO and UN recommend it after c/s as soon as mom is alert and responsive. Stikes & Barbier, 2013 PT, used PDSA cycle and strategies to decrease barriers to increase KC in NICU by 31% over 6 months. Quality Improvement Project Toeftland et al., 2006 FT, change in bf rates due to maternal feedback from 1994 til 2001. KC time was an influencing factor. Toma 2003 PT, descriptive study of issues related to implementation in rural communities of Brazil. Managing family issues improves their use of KC for sick newborn. Treleaven, 2012 Report of 1st International Caribbean and Latin American KMC conference in Dec. 2011 for improving implemention and establishing standardized evaluation criteria and ways to sustain KMC practice. UNICEF 1998 FT, assesses barriers to implementation of the 1989 and 1992 guidelines and provides new guidelines FOR NATIONAL implementation of Birth KC and Very Early KC components of the Baby Friendly initiative Vial-Courmont 2000. PT Polish report of Paris experience at Clamart Academic Hospital where KC began in 1987. Article discusses organization of KC ward, list advantages of kc as continuous contact, less maternal anxiety, better well- being of child, more efficient maternal involvement Varner 2008 FT, commentary on Smith et al., 2008 and talks about birth KC with cesareans being controversial and how publishing controversial approaches affects implementation world wide. Vasquez & Berg, 2012 FT, implementation of Baby Friendly was impeded by hospital’s lack of support for rooming=in and skin-to-skin contact. Took 8 years to do!

Victora et al. 2010 PT, talks about barriers to scale of up of KMC to reduce preterm birth morbidity and mortality. Provides good list of barriers and good considerations specific to KMC. PUBLIC HEALTH PERSPECTIVE Wallin et al., 2005 PT, report that using a facilitator to a change team to implement KMC guidelines was no more effective than Quality assurance organization in which nurse manager was involved in implementing the KMC guidelines. Walters et al., 2007 FT implementation trial of Birth kc in a US inner city hospital. Warren, 2008 FT, implementation of BirthKC: biggest obstacle is change in routine Weddig et al.. 2011 FT, RCT of BFHI education who did/did not complete on line course, Treatment group did little to change positioning, initiation, milk transfer and documentation behaviors but did change formula supplementation. Treatment nurses did more than non-treatment nurses. One year after education complete.

WHO/UNICEF 1989 FT guidelines and criteria (Step 4 addresses VEKC) for implementing Baby Friendly WHO/UNICEF 1992 FT guidelines and criteria (Step 4 addresses VEKC) for implementing Baby Friendly Zambito et al 2010 FT, Quasi-exp to introduce birth KC to nurses.38 RNS volunteered and took tests related to article and policies and had supervised skills, scripted talks to parents, etc. and “Nurses changed practice and implementation of KC significantly increased.”pg S109.