Implementation and Evaluation of the Sacred Hour Protocol for Well-Appearing Term Infants affected by Maternal Chorioamnionitis

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Finch, Nicole
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2018-05-12
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Background: Newborns affected by maternal chorioamnionitis in the project hospital were immediately admitted to the neonatal intensive care unit (NICU) after delivery eliminating the possibility of completing the hospital’s Sacred Hour Protocol. The Sacred Hour Protocol encourages skin-to-skin (STS) time for the first hour of life to promote bonding and breastfeeding establishment.|Significance: Successful breastfeeding establishment has been associated with improved neonatal outcomes whereas early separation of the newborn from its mother has been associated with increased mortality rates.|Purpose: To establish a protocol which would permit well appearing term infants to be placed STS with their mother prior to NICU admission to promote breastfeeding establishment.|Methods: Following normal newborn resuscitation, well appearing chorioamnionitis newborns were assessed using the Kaiser Sepsis Calculator (KSC) to determine risk of sepsis. Those with a low risk of sepsis were placed STS prior to NICU admission.|Results: A total of 26 newborns were included in the project sample and were compared to a control sample of 39 newborns. Of the project sample, 65% (n=17) received STS and 35% (n=9) were directly admitted (DA) to the NICU. Breastfeeding success rates at discharge were 21.4% (n=3) in the STS group compared to 12.5% (n=1) in the DA group and 11.1% (n=4) in the control group. Mean breastfeeding initiation time was 9.6 hours after birth in the STS group compared to 13.1 hours in the DA group and 12.6 hours in the control group.|Discussion: Results showed improved breastfeeding initiation times and higher breastfeeding success rates at discharge for those who received any amount of STS time. The KSC effectively identified those infants at highest risk of sepsis, and not a single case of sepsis was missed.
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University
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