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Therapeutic Touch

Therapeutic Touch. Kangaroo Holding. Kangaroo Care. Developing attachment in the NICU Skin to skin contact is the most preferred intervention to decrease neonatal morbidity and mortality Short term goal- maintain temperature. Kangaroo Care. Began 1980’s in Bogata, Columbia

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Therapeutic Touch

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  1. Therapeutic Touch Kangaroo Holding

  2. Kangaroo Care • Developing attachment in the NICU • Skin to skin contact is the most preferred intervention to decrease neonatal morbidity and mortality • Short term goal- maintain temperature

  3. Kangaroo Care • Began 1980’s in Bogata, Columbia • Practice spreading worldwide because of benefits • Germany- if baby under 500 grams • South Africa- opportunity for breastfeeding • Zimbabwe- mortality reduced 40% • Now practiced in 25 developing countries and many industrialized countries

  4. Pathophysiology • Benefits to the infant; • Breathe better • Regulate heart rate- reduces dramatic increases • Analgesic effect • Doubles sleep time • Increased mouthing movements

  5. Pathophysiology • Many other benefits; • Improve breast feeding- duration increased by 8 weeks • Promotes breastfeeding • Supports growth and development • Thermoregulation • Mother is preferred heat source • Neutral thermal range with skin contact • Mother adapts body temp for newborn

  6. Psychological • Shown to have positive effects on mother-infant bonding, stress reducing for both • Improves birthing experience for mother and father • Mothers demonstrate more maternal affection behaviors • Provides tactile comfort and verbal interaction • Enhanced father participation • Decreases maternal post partum depression

  7. Women’s Health • Promotes a mother’s sense of confidence and independence • Enables woman promote the health and well being of her and her child • Will initiate the bonding pattern • Most nurses did not view kangaroo care as an added burden • Main goal is support parental confidence and competence

  8. Women’s Health • Nurses need to be there to provide information and offer support especially LBW babies • Fewer nurses needed to assist with normal term infants • Some nurses may feel frustration • Nurses feel benefits of kangaroo care can result in less workload for staff

  9. Potential Risks and Concerns • These are intensive care patients with multiple precautions noted. • Nurses often concerned with accidental dislodgement of lines, mechanical ventilation, etc. • Required monitoring and appropriate education for both mother and father • Education of the benefits of kangaroo care is a pivotal role for the nurse providing care • Nurse self-awareness regarding kangaroo care

  10. Interventions • Immediate skin to skin contact with mother post delivery • Dry baby put on hat and diaper, place on mother with warm blanket • Obtain APGAR scores, place I.D. bands • Vit K and Erythromycin after feeding • Other assessments after feeding

  11. Interventions • Skin to skin contact for first 24 hours of life and beyond • Minimize tasks that remove baby from mother immediately after birth

  12. Nursing Implications • Promote education, parent teaching • Effortless and no cost considerations • Consider condition of infant • Staff assistance to prevent dislodging infusion lines • Organizational support- guidelines and protocols

  13. Nursing Implications • Nurse educator- • teaching principles in prenatal classes • Discuss fundamental role • Use of visual aids, reading materials • Discussion board, phone call follow-up • Nursery nurse- • Front line educators • Adequate rest and pain management • Documentation on discharge paperwork

  14. Nursing Implications • Pediatric nurse- • In-service on kangaroo care • Modifications to environment • Community health nurse- • Required in order to take practice beyond the NICU

  15. References • Chia, P. (2006). The Attitudes and Practices of Neonatal Nurses in the use of Kangaroo Care. AustralianJournal of Advanced Nursing , 20-27. • Johnson, A. N. (2005). Kangaroo Holding Beyond the NICU. Pediatric Nursing , 53-56. • Kostandy, R., Ludington-Hoe, S., & Cong, X. (2008). Kangaroo Care (Skin Contact) Reduces Crying • Response to Pain in Preterm Neonates: Pilot Results. Medscape , 55-65. • Images: • www.digitalfieldguide.com/blog/page/35 • http://graphics.iparenting.com/clipart/newfamily/E009344L.JPG • www.adnb.govt.nz/.../KangarooCare.htm • http://moosekisspress.com/synopsis.html

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