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 1^st 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.
  • 1^st 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 1^st day letter to Nurses (5) Each family was provided with a folder which included:  1^st 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 1^st 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!

The post Creativity and Kangaroo Care at UMass Memorial! appeared first on Your Health Matters.

We asked this team why they thought they won, and what tips they might have for other units who want to improve their kangaroo care or skin to skin holding rates. As befits a champion, they had excellent advice to share with us all.  In their own words …

Why did we win? 

We took a QI approach.
We have a team.
We had a SMART AIM:  to have an average skin to skin time of 2.5 hours per baby per day during our two week Kangaroo “Throw Down” from 5/4-5/17/2015.
We identified key drivers: look at/know/share your data, awareness/ visibility, engagement of all caregivers and families, small rewards, understanding importance/rationale of skin to skin.
We measured daily.

We marketed it beforehand in multiple ways.
Everyone knew our goal was 2.5 hours/baby/day.
We discussed it at daily huddles.
It was on our visibility window.
We planned celebrations during it.
We had daily small drawings for prizes and a larger reward at the end.
We all knew that we were competing with other NICUs.

We made our results very visible.
We sent daily emails with how we did each day.
Run Chart updated daily in the Nurse’s station and pointed out during huddle.

We celebrated.
We combined Kangaroo Care, Nurses’ Day, Mother’s Day Cake and Coffee Bar.
We held a Pocket Sandwiches Day.
Kangaroo gifts for families.
Daily raffle/prizes for staff  and overall end of event raffle prize for staff and NICU families.

We have a long-standing focus on parents/babies doing skin to skin.
Early on we had a nurse and physician champion.
Our QI project in NICQ 8 was to decrease time to first skin to skin after admission.
It is standard work already in our NICU.
It ‘s part of Family Integrated Care work.
It’s part of a broader focus for all families delivering in our Family Birth Center

This is part of our NICU culture—we are believers in skin to skin.
Skin to skin is an important part of care and not just something nice to do (an “add on”).

And finally ….
We involved organizational leadership (Nursing Director, CNO).
Our Parent Action Committee members were on our team.
We have wonderful parents/ families in our NICU.
The Oregon effect.

Here are some photos of the great folks at Salem doing what they do best … working together and making magic happen for babies and families. 

So, do you want to beat Salem next year?  They have kindly told us all exactly what we need to do if we want to take their crown. 

Set a goal. We suggest at least 3 hours/baby/day.
Market it.
Celebrate.
Help everyone understand the evidence–why skin to skin holding is an essential part of care.
Make skin to skin holding an expectation. Discuss at rounds and with families frequently.
Don’t forget dads.
Build documentation of S2S time into bedside work flow.
Continue to measure and share the results throughout the year.

Salem, we salute you!  Not just your tremendous focus on reuniting babies with their families, but also the generosity of spirit shown by how you share the secrets of your success.  You are true champions, each and every one of you. 

Check back next week for some more stories of success from some of the 38 hospitals involved in this amazing project. Until then, happy holding!

The post Kangaroo Throw Down … We have a WINNER! appeared first on Your Health Matters.

At Sunnybrook, we issued our Kangaroo-a-thon Throw Down a few months ago, and we are  happy to report that 35 hospitals across North America have joined in!  Many of these hospitals have been promoting and supporting kangaroo care for years, and we have learned so much from their examples. We will have final results by the end of May, but we can state already that all of you who participated (especially the babies) are gold medal winners in our eyes.

We are also beyond thrilled to learn that the Miracle Babies Foundation in Australia is leading their own Kangaroo Throw Down! This organization does incredible work supporting families and health care workers in hospitals across Australia, and it seems fitting that they are such ardent champions of kangaroo care. Be sure to check out the beautiful pictures they are sharing via their Twitter account. We await the results of their throw down with great anticipation, and we will send whoever wins their throw down something exciting!

And last (but certainly not least), today we will be wrapping up the Sunnybrook Instagram #SBcuddles contest!  Thanks so much to all the families who shared their wonderful kangaroo care moments.

Happy holding, everyone!

The post Happy International Kangaroo Care Day! appeared first on Your Health Matters.