How to Engage Your Team to Implement Delayed Cord Clamping

Gams, Rebecca; Popp, Kimberly Kay; Cramer, Julianne; George, T. Neville; Rauk, Phillip N.; Sommerness, Samantha A.; Sublette, Jane A.

doi:10.1016/j.nwh.2017.10.003

Cited by 10 publications

(3 citation statements)

References 23 publications

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“…A study, which described how the change in the practice of umbilical cord clamping and its recording occurred within a health team, through the creation of institutional guidelines, reported that through protocols and teamwork it was possible to succeed in the implementation of delayed/optimal clamping as a routine practice and, also, to replicate the strategy in five other institutions (27) , reinforcing the importance of standardizing the procedure and raising professional awareness about the implementation of good care practice.…”

Section: Descritoresmentioning

confidence: 99%

Factors associated with umbilical cord clamping in term newborns

Strada

Vieira

Gouveia

et al. 2022

Rev. esc. enferm. USP

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OBJECTIVE: To identify factors associated with umbilical cord clamping in term newborns and to compare the recording of clamping time in the medical record with what was observed. METHOD: Cross-sectional study, with 300 mothers-infants, in a university hospital. Clamping time and medical records were observed, and a structured questionnaire was applied to postpartum women for sociodemographic variables. Bivariate analysis, multivariate Poisson Regression model, and Kappa concordance test were performed. RESULTS: The percentage of late/optimal clamping observed was 53.7%. The associated factors were skin-to-skin contact in the delivery room (PR = 0.76; 0.61–0.95; p = 0.014), position of the newborn below the vaginal canal (PR = 2.6; CI95%: 1.66–4.07; p < 0.001), position of the newborn at the vaginal level (PR = 2.03; CI95%: 1.5–2.75; p < 0.001), and need for newborn resuscitation in the delivery room (PR = 1.42; CI95%; 1.16–1.73; p = 0.001). Kappa concordance level of the professionals, records compared to the observation was: nurse 0.47, obstetrician 0.59, and pediatrician 0.86. CONCLUSION: the identification of associated factors and the comparison between recording and observing the clamping time can help in the planning and implementation of improvements for adherence to good practices at birth.

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Section: Descritoresmentioning

confidence: 99%

Factors associated with umbilical cord clamping in term newborns

Strada

Vieira

Gouveia

et al. 2022

Rev. esc. enferm. USP

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“…13 Higher rates are noted by direct observation. 16 More recent work on implementation of ‘delayed’, ‘physiological’ or ‘wait a minute before’ clamping, in countries as far away as Peru, 17 Norway, 18 India 19 and the USA 20 has shown the possibilities and difficulties in changing birth practices. We cannot find work auditing recent UK practice.…”

Section: Premature Cord Clamping (Control)mentioning

confidence: 99%

Improbable, but plausible, research study: a randomised controlled trial of premature cord clamping vs. neonatal venesection to achieve routine prophylactic neonatal red cell reduction

Weeks

Bewley

2018

J R Soc Med

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“…3 Thus, at the time of birth, immediate cord clamping is more of an ingrained practice. 4 Moreover, mother's care takes priority at the time of delivery and simpler interventions like delayed cord clamping (DCC) and early breastfeeding initiation (EBFI) are ignored many times. Apart from these challenges, lack of awareness of best practices, lack of formal training and poor coherence within the working team contribute to poor compliance.…”

Section: Introduction Problem Descriptionmentioning

confidence: 99%

Sustaining immediate newborn care processes (delayed cord clamping and early breastfeeding initiation) in the delivery room: a quality improvement study

Nagendla¹,

Manju²,

Aradhya³

et al. 2022

BMJ Open Qual

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BackgroundImmediate newborn care processes like delayed cord clamping (DCC) and early breastfeeding initiation (EBFI) in the delivery room have several benefits including survival. Despite the evidence, the practices have not been widely adopted. We used a point-of-care quality improvement (QI) to implement and sustain these two immediate newborn care processes in our delivery room over a period of 2 years through a series of plan–do–study–act (PDSA) cycles.MethodsAll neonates above 30 weeks of gestation irrespective of the need for resuscitation except Rh-isoimmunisation were eligible for DCC. Neonates >35 weeks not requiring respiratory support or resuscitation were eligible for EBFI. The root causes of gaps in the quality were analysed by fishbone analysis. The key quantitative outcome measure was the percentage of eligible deliveries in which DCC and EBFI were done. Duration of DCC was also recorded in the sustenance phase. This implementation was done through three PDSA cycles and the practices were sustained for 2 years.ResultsA total of 770 deliveries were part of this QI study from October 2018 to December 2020. There was a significant improvement in DCC (median) from a baseline of 25% to 96% over a 2-year period. Sensitisation, making DCC part of pre-birth checklist and recording outcomes on a dashboard daily helped to implement and sustain the processes over 2 years. As a co-process, EBFI improved (median) from a baseline of 50% to 97% without any major intervention in the system.ConclusionsImmediate newborn care processes could be sustained by making them part of pre-birth preparation and dashboard recording by a QI initiative without any additional resources.

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How to Engage Your Team to Implement Delayed Cord Clamping

Cited by 10 publications

References 23 publications

Factors associated with umbilical cord clamping in term newborns

Factors associated with umbilical cord clamping in term newborns

Improbable, but plausible, research study: a randomised controlled trial of premature cord clamping vs. neonatal venesection to achieve routine prophylactic neonatal red cell reduction

Sustaining immediate newborn care processes (delayed cord clamping and early breastfeeding initiation) in the delivery room: a quality improvement study

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