Early Kangaroo Mother Care (Kmc) Adoption In The Neonatal Intensive Care Unit: A Quality Improvement Initiative

Abstract

Background: Kangaroo Mother Care (KMC) is a proven intervention that enhances thermoregulation, promotes bonding, and improves neonatal outcomes, particularly among preterm and low birth weight infants. Despite well-established benefits, timely initiation of KMC—referred to here as early KMC (KMC)—remains suboptimal in many Neonatal Intensive Care Units (NICUs). Barriers such as lack of standardized protocols, insufficient staff training, and limited parental engagement delay the timely adoption of KMC.

Methods: We conducted a quasi-experimental quality improvement study in the NICU of Saveetha Medical College, Chennai, from January 2023 to September 2024. Eligible neonates included all preterm infants regardless of birth weight and term neonates weighing under 2500 g, excluding those with contraindications or mothers unavailable for KMC. A baseline assessment (January–December 2023) quantified current KMC initiation rates. Subsequently, four Plan-Do-Study-Act (PDSA) cycles were executed to address identified barriers. Interventions included standardized protocols, staff training, enhanced parental education, and infrastructural adjustments (e.g., increasing KMC chairs).

Results: Baseline data indicated that only 50% of eligible neonates received KMC within the first 24 hours. Post-intervention, this figure increased to 76%. Staff knowledge surveys showed a 50% improvement in awareness and proficiency, while parental engagement rose significantly, with more families participating in KMC sessions. Statistical analyses (chi-square and t-tests) demonstrated that the increase in KMC initiation was both clinically and statistically significant (p < 0.05).

Conclusion: A systematic quality improvement strategy combining protocol standardization, focused staff education, parental engagement, and resource maximization can significantly enhance the timely initiation of KMC in a resource-constrained NICU setting. Scaling up such efforts has the potential to improve neonatal outcomes by lowering barriers to early KMC initiation.