Date of Completion
Fall 2026
Document Type
DNP Scholarly Project
Academic Department
School of Nursing
Degree Type
Doctoral
Degree Name
Doctor of Nursing Practice
First Advisor
Ebony Parker, DNP, RN, WHNP-BC
Second Advisor
Lydia Forsythe, PhD, MA, MSN, RN, CNOR
Third Advisor
Melanie Brewer, DNSc, RN, FNP-BC, NEA-BC, FAANP
Abstract
Problem: Immediate skin-to-skin care (SSC) remains inconsistently implemented, despite evidence linking it to improved neonatal outcomes. At the project site, baseline SSC rates were 64% for vaginal births and 19% for Cesarean births, below the 80% standard established by the Baby-Friendly Hospital Initiative.
Aim of the Project: This QI project aimed to improve outcomes by implementing evidence-based SSC practice and first-hour breastfeeding initiation to align with Baby-Friendly standards.
Review of the Evidence: The applied interventions align with the seminal guidance from the World Health Organization and the United Nations Children’s Fund, which represents the global standard for maternity and newborn care.
Project Design: Over 12 weeks, an interdisciplinary team applied Baby-Friendly practices for clinically stable Labor and Delivery patients. The team used Plan-Do-Study-Act (PDSA) cycles to evaluate implementation effectiveness and refine strategies.
Intervention: Interventions included staff education, leadership engagement, visual reminders, patient education, and biweekly data analysis. When breastfeeding compliance temporarily declined during implementation, the team introduced a variety of daily educational sessions and increased site visits. Clinical champions were essential to enhancing staff engagement and improving documentation accuracy.
Significant Findings/Outcomes: Compared to the 12-week pre-implementation data, overall SSC occurrence increased from 79.28% to 86.34%, and SSC compliance increased from 75.67% to 84.49%, exceeding the 80% benchmark. The most notable improvements were observed in Cesarean births, with SSC occurrence increasing from 61.78% to 74.80% and compliance from 57.90% to 73.23%. Full documentation of SSC times increased from 50.99% to 59.99%. No significant increases were observed in breastfeeding initiation rates within the first 2 hours of delivery.
Implications for Nursing: This data-driven, iterative QI approach effectively standardized SSC practices, with notable improvements in Cesarean rates. Interdisciplinary education, dedicated champions, leadership engagement, and PDSA strategies are key to sustaining Baby-Friendly practices and enhancing the delivery of evidence-based maternal-newborn care.
Recommended Citation
Grace, Brianna, "Baby-Friendly Implementation for Decreased Skin-to-Skin Care Initiation Delays" (2026). All Doctor of Nursing Practice (DNP) Scholarly Projects. 99.
https://fuse.franklin.edu/dnp-project/99
Rights
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