Post on 02-Apr-2018
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Module: Skin-to-Skin Care Session 1
Module Overview Visual 1
Module Overview: Purpose
The purpose of this module is to provide facilitators with
a sound, competency-based training (CBT)
methodology which if implemented as designed, willresult in physicians attaining mastery of the knowledge,
competencies, and skills required to identify and
manage neonates on skin-to-skin care.
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Module: Skin-to-Skin Care Session 1
Skin to Skin Care
Ayman El-Mohandes, MD, MPH, FAAP
The George Washington University
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Module: Skin-to-Skin Care Session 1
Module Overview Visual 3
Module Overview: Story
Skin-to-skin care, also referred to as kangaroo care, is a form
of parent-neonate interaction in which the mother holds her
neonate skin-to-skin in a vertical, head-up position on or
between her breasts for twenty minutes or longer. This type of
contact provides an appropriate thermal environment while
conferring many physiological and emotional benefits to both
neonate and mother. Egyptian hospitals have not used skin-to-
skin care extensively.
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Module: Skin-to-Skin Care Session 1
Module Overview Visual 4
Module Overview: Story (cont.)
Existing evidence suggests that mothers and infants inIndonesia, especially preterm/LBW infants, would
benefit from increased use of skin-to-skin care, forinfants born in and outside facilities. Preliminaryevidence also exists that Indonesian mothers have adesire to learn and practice this type of care. It is
important that midwives, nurses and physicians areknowledgeable in promoting, selecting, and managingneonatal skin-to-skin care..
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Module: Skin-to-Skin Care Session 1
Task Analysis Visual 5
Task Analysis: Task
Complete a Newborn Assessment and Implement
Admission and Discharge Policies and Procedures
According to the Service Standards and Protocol toEnroll and Manage Neonates Suitable for Skin-to-Skin
Care.
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Module: Skin-to-Skin Care Session 1
Task Analysis Visual 6
Task Analysis: Competency 1
1. Competency: Promote Skin-to-Skin Care of the
Neonate
Skills1.1. Select neonates appropriate for skin-to-skin care.
1.2. Educate mothers about the advantages of skin-to-skin
care.
1.3. Prepare neonates for skin-to-skin care.
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Module: Skin-to-Skin Care Session 1
Task Analysis Visual 7
Task Analysis: Competency 1
1. Competency: Promote Skin-to-Skin Care of the
Neonate (cont.)
Skills1.4. Prepare parents for skin-to-skin care.
1.5. Monitor the vital signs and oxygenation of the neonate
during skin-to-skin care.
1.6. Identify any persistent signs of stress, and manageaccordingly.
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Module: Skin-to-Skin Care Session 1
Session Purpose Visual 8
Session 1: Purpose
The purpose of this session is to introduce participants
to the concepts, benefits, implementation, and
management of skin-to-skin care. Criteria for selection
of neonates appropriate for this kind of care, as well aspreparation of the neonate and parents for skin-to-skin
care, will be reviewed.
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Module: Skin-to-Skin Care Session 1
Session Story Visual 9
Session 1: Story
Skin-to-skin care, also referred to as kangaroo care, is
a form of parent-neonate interaction in which the
mother holds her neonate skin-to-skin in a vertical,head up position on or between her breasts for 20
minutes or longer.
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Module: Skin-to-Skin Care Session 1
Session Story Visual 10
Session 1: Story (cont.)
This type of contact: Provides an appropriate thermal environment.
Improves oxygenation.
Decreases apnea and bradycardia.
Facilitates early breastfeeding. Increases duration of lactation.
Lowers caloric expenditures.
Improves weight gain.
Increases time in optimal behavioral states. Promotes parental attachment and bonding.
Shortens hospitalization period.
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Module: Skin-to-Skin Care Session 1
Learning Objectives Visual 11
Learning Objectives1. Define skin-to-skin care and know the criteria used
to select neonates for this type of care.
2. Educate mothers about the advantages of skin-to-skin care.
3. Prepare neonates for skin-to-skin care.
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Module: Skin-to-Skin Care Session 1
Learning Objectives Visual 12
Learning Objectives (cont.)4. Prepare parents for skin-to-skin care.
5. Monitor the vital signs and oxygenation of the
neonate during skin-to-skin care.6. Identify any persistent signs of stress and manage
accordingly.
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Module: Skin-to-Skin Care Session 1
Learning Objective 1 Visual 13
Skin-to-Skin Care
Definition
Skin-to-skin care, also referred to as "kangaroo care", is a
form of parent-baby interaction in which the mother holds
her infant skin-to-skin in a vertical, head up position on or
between her breasts for 20 minutes or longer.
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Learning Objective 2 Visual 15
Advantages of Skin-to-Skin Care
Mothers, fathers, and health care personnel need to
know the advantages of this type of therapy in order
to promote its adoption and use.
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Module: Skin-to-Skin Care Session 1
Learning Objective 2 Visual 16
Advantages of Skin-to-Skin Care
Provides an appropriatethermal environment
Improves oxygenation.
Decreases apnea andbradycardia.
Facilitates earlybreastfeeding.
Increases duration oflactation
Lowers caloricexpenditures.
Improves weight gain.
Increases time in optimalbehavioral states.
Promotes parentalattachment and bonding.
Shortens hospitalizationperiod.
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Module: Skin-to-Skin Care Session 1
Learning Objective 3 Visual 18
Management Guidelines for Skin-to-
Skin Care
Physicians and nurses should decide which infants
are appropriate for skin-to- skin care and provide
parents with sufficient information describing the
advantages of the technique. It is extremely
important to remember that everyone involved should
be comfortable and supportive of the decision to hold
the infant skin-to-skin.
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Module: Skin-to-Skin Care Session 1
Learning Objective 3 Visual 19
Preparation of the Neonate for Skin-
to-Skin Care
Once the decision has been made, the infants temperature
should be assessed at 36 C or greater and documented on
the flow sheet.
A skin temperature probe can be left on and all other monitorwire, intravenous lines, and respiratory support tubes should
be secured.
The infant can be undressed except for a diaper. Hats are
generally not necessary unless the infant weighs less than1,000 grams.
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Module: Skin-to-Skin Care Session 1
Learning Objective 4 Visual 20
Preparation of the Parents for Skin-
to-Skin Care
Carefully explain the advantages of this type of care
for their infant.
Demonstrate the type of holding they will do. Encourage the mother to wear a front-opening shirt
or cover gown so she can provide this care in a
modest manner.
Provide as much privacy and quietness as possible.
M d l Ski t Ski C S i 1
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Module: Skin-to-Skin Care Session 1
Learning Objective 5 Visual 21
Monitoring the Neonate on Skin-to-
Skin Care
Once the infant has been successfully transferred to
the parent, the infants vital signs and oxygenation
status should be monitored, and adjustments made
based on the infant's status.
M d l Ski t Ski C S i 1
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Module: Skin-to-Skin Care Session 1
Learning Objective 6 Visual 22
Signs of Stress during Skin-to-Skin
Care
The infant should be returned to the incubator if any
persisting signs of stress are identified, including
tachypnea, tachycardia, temperature instability, or
oxygen desaturation.
The length of time for holding is individually based
and depends on the neonates status and parental
comfort.
Module: Skin to Skin Care Session 1
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Module: Skin-to-Skin Care Session 1
Learning Objectives Visual 23
Summary: Learning Objectives1. Define skin-to-skin care and know the criteria used
to select neonates for this type of care.
2. Educate mothers about the advantages of skin-to-skin care.
3. Prepare neonates for skin-to-skin care.
Module: Skin to Skin Care Session 1
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Module: Skin-to-Skin Care Session 1
Learning Objectives Visual 24
Summary: Learning Objectives
(cont.)4. Prepare parents for skin-to-skin care.
5. Monitor the vital signs and oxygenation of the
neonate during skin-to-skin care.6. Identify any persistent signs of stress and manage
accordingly.