Inside the NICU

Creativity and Kangaroo Care at UMass Memorial!

We have been receiving so much amazing material from hospitals who participated in the first Kangaroo Throw Down, and we want to keep sharing it with you all. We heard this week from the fantastic team at UMass Memorial in Worcester MA.  They did a great job with their first ever Kangaroo-a-thon, but we really want to single them out for their incredible creativity. You’ll see from the photos in the gallery that they have some really crafty, artistic people on their team.

We also LOVED their Senior Neonatology Fellow who spread some joy by dressing like a kangaroo. To him we say: “You’re a kangaroo hero!”

They also shared some tips about what worked for them and some advice for other hospitals. You’ll notice some similarities between their top tips and those shared last week by our challenge winners. Both units pointed out the importance of measurement, goal-setting, and celebration. But let’s hear what UMass had to say – straight from the kangaroo’s mouth (as it were):

Developing and Implementing Kangaroo Care Practice in the NICU at Umass Memorial Hospital

  • Aim:  80% of infants in the NICU are held within 5 days of admission by September 2015.
  • Methods:  A Kangaroo Care Task Force was created involving nursing, the nurse educator, physician leaders (Attending & Fellow), NNPs and child life.  Meetings were held December 2014-May 2015 every 2-3 weeks for ~1-1.5hours.
    • Identifying Barriers: Initial nursing survey was created and implemented using SurveyMonkey.com. There was ~75% participation from all the nursing staff. This survey helped to identify the barriers of providing Kangaroo Care in our NICU.
    • Exclusion Criteria Developed for Kangaroo Care: Based on an extensive literature review as well as taking into consideration of the nursing survey, exclusion criteria were devised. Infants not eligible for kangaroo care were infants with a UAC/Chest tube, ELBW < 5 days old, phototherapy >2 lights, receiving ionotropic support/EEG monitoring/iNO and post op for 1st 48h.
    • Staff & Family Education: (1) Members of the Kangaroo Care Task Force updated a nursing bulletin board every 2 weeks with information on the importance of Kangaroo Care, Kangaroo Care facts, the newly devised Kangaroo-Care exclusion criteria, results from the initial nursing survey and advertising of the upcoming Kangaroo-a-thon (2) An online education module was sent out to all the nursing staff with a 7 –question post test to help ensure that the staff were educated. (3) An informative binder with the new Kangaroo exclusion criteria was created by the members of the Kangaroo Care Task force. Several members of the Kangaroo Care Task Force took responsibility to review the information with the nursing staff individually. Each nurse provided their signature when they received the training. (4) Members of the Kangaroo care task force created an education pamphlet for parents. These pamphlets were placed in their admission packet. These pamphlets noted the expectations of them while providing kangaroo care including describing to parents the importance of kangaroo care.
  • Kangaroo-a-thon: To increase the frequency and awareness of kangaroo care, we participated in a world wide competition organized by Sunnybrook Hospital. We held our first ever Kangaroo-a-thon from May 1st to May 14, 2015.
    • Advertisement prior to the event:  (1) Kangaroo-a-thon was advertised with posters at the entrance of the NICU ~ 1 week prior to the event. (2) The nursing bulletin advertised the event (3) The windows to the family room were painted with pictures of woman providing Kangaroo Care.
    • 1st Day of the Kangaroo-a-thon: (1) A family brunch was held. (2) Our senior neonatology fellow dressed up as a Kangaroo and handed out Kangaroo stickers and labeled Kangaroo Hershey Kisses to the families and staff. (3) Several staff wore special t-shirts – “Keep Calm and Kangaroo On”. (4) Special 1st day letter to Nurses (5) Each family was provided with a folder which included:  1st Day Letter , Log sheet for the families to log the hours of Kangaroo care, Laminated Kangaroo picture with a baggie of foam hearts to be placed for each Kangaroo session, Laminated card which noted the 10 reasons to practice Kangaroo Care (special permission from Boba.com to copy & distribute). (6) Each nurse received a 1st day letter.
    • Mother’s Day Brunch: This brunch was sponsored by the physicians of the NICU. Each family received a hand held mirror so they could watch their own Kangaroo Care.
    • Daily rewards/advertising: (1) We rewarded both the parents and all assisting staff for every hour of Kangaroo care that was provided. For every hour of Kangaroo Care, the parents and the nurse/assistant were given a raffle ticket and entered into a weekly raffle. Each week, the nurses received a gift card and the parent received a t-shirt, stuffed Kangaroo and a gift card. (2) For every Kangaroo care sitting, a heart sticker was placed on their bedside laminated Kangaroo. (3) At the end of each day, the hours were tallied up and stickers were placed for every 10hours of kangaroo-care on the Kangaroo Land Poster  (similar to Candy Land) that was placed at the entrance of the NICU. (4)  For every hour of Kangaroo Care, a cut out Kangaroo was placed on the entrance wall of the NICU (5) Parents were also encouraged to place heart sticker on their bedside laminated Kangaroo.  (6)  Parents were encourage to keep track of their own daily success on a log (7) Weekly success posted on NICU Parent Facebook page (8) Parents and staff were encourage to write in an anonymous journal posted by the raffle bowl about what they enjoyed about Kangaroo care. (1) Advertised in our hospital online newsletter
    • Kangaroo-a-thon Results/Discussion: We found the kangaroo-a-thon to be a success. We set a goal of 200 hours and succeeded our goal – 472 hours! Our plan is to join the Kangaroo-a-thon competition next year.
    • Improvements for the Kangaroo-a-thon: Our Kangaroo Care Task Force will be meeting as a group soon. However, at this point, we hope in the future to (1) Involve more senior leadership (2) Involve the parent advisory committee (3) Avoid the expense of color copies/photos/lamination (4) Consider posting more statistical measures – updating a run chart daily or sending daily emails with the success (5) Create a post Kangaroo-a-thon survey (6) We reached out to local newspaper/television station during the event. May need to consider setting this up prior to the event.
  • Results/Discussion: In the process of reviewing the data. We identified with this process that a barrier is data collection. It was very time consuming to find information as we didn’t have a standardized way to chart first hold. A stamp was placed in the chart in March 2015 to help with documentation as well as an additional stamp on the daily flow sheet in April 2015.

Thank you so much to the team at UMass for sharing, and for putting so much creative and compassionate energy into your Kangaroo-a-thon. You’re fabulous!

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Kate Robson