Redwood City is one of only seven Kaiser Permanente facilities in the Northern California region with a Special Care Nursery (SCN). SCN nurses specialize in stabilizing newborns with a range of medical needs including premature birth, infection, or respiratory issues. They also promote parent involvement and education to build confidence in caring for a healthy newborn.

Joanne Leslie, MSN, RN, RNC-NIC, SCN Staff Nurse IV, observed that many newborns who experienced neonatal hypothermia, or low body temperature, were admitted to the SCN. She knew evidence supports skin-to-skin contact as an effective and economical treatment for mild hypothermia in neonates and believed some admissions to SCN could be avoided, and keep fragile newborns with their parents.

Leslie was accepted into the KP-sponsored Evidence-based Practice (EBP) Immersion Program and began her clinical inquiry on the impact of skin-to-skin contact on babies with mild hypothermia.  Her literature search confirmed that skin-to-skin contact is cost-effective and promotes parent bonding.

With leadership support, Leslie developed an EBP quality improvement intervention that included peer-to-peer education for labor and delivery (L&D), mother-baby, and SCN staff.  She shared education at staff meetings and created a poster outlining neonatal hypothermia, proper skin-to-skin technique, and guidance for parent education. Additionally, she developed an algorithm for postpartum staff to ensure all steps were attempted before transferring a baby to the SCN.

In her pre-intervention analysis 12 months before the intervention, Leslie identified 19 SCN  admissions that were primarily for rewarming. In the 8-months following her intervention, only six babies required SCN admission for rewarming. Leslie’s impressive work reduced parent-newborn separation and decreased SCN admissions, an outstanding example of frontline innovation improving patient care.