Background: There are many barriers to parental skin-to-skin contact for critically ill neonates. Our aims were to decrease median time to first parental hold of neonates requiring respiratory support from 6.4 to 3 days, and to increase the percentage of neonates held within the first 24 h after birth from 6 to 75%.
Methods: Lean Six Sigma methodology was used to identify barriers to holding and opportunities for improvement.
Intervention: A multifactorial improvement bundle was implemented to reduce the time to first parental hold of critically ill neonates.
Results: Median time to first parental hold was reduced from 6.4 to 1.2 days (p < 0.01). Infants held within the first 24 h after birth increased from 6 to 35%. There was no increase in adverse events associated with parental holding.
Conclusions: Implementation of an improvement bundle resulted in a significant reduction in time to first parental hold of infants requiring respiratory support.