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Barriers to Skin-to-Skin Contact after Cesarean Birth

MCN: The American Journal of Maternal/Child Nursing: May/June 2019 - Volume 44 - Issue 3 - p E9–E10
doi: 10.1097/NMC.0000000000000546
CE Connection
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Barriers to Skin-to-Skin Contact after Cesarean Birth


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General Purpose:

To provide information on obstetric nurses' perceived barriers to immediate skin to skin contact (SSC) in the operating room after cesarean birth.

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Learning Objectives/Outcomes:

After completing this continuing education activity, you should be able to:

  1. Summarize issues related to the use of SSC.
  2. Identify perceived barriers to immediate SSC after cesarean birth as reported by obstetric nurses.
  1. As noted in the article, benefits of SSC include
    1. improvement in the neonate's lung function.
    2. normalization of the neonate's blood glucose.
    3. improved immune function in the neonate.
  2. Crenshaw (2014) reported that immediate SSC is usually defined as being performed within how many minutes after birth?
    1. 5 minutes
    2. 10 minutes
    3. 15 minutes
  3. According to Crenshaw (2014), all routine assessments and procedures on the neonate should be performed after how much SSC time?
    1. 15 minutes
    2. 30 minutes
    3. 1 hour
  4. Hung & Berg (2011) reported that it is reasonable after cesarean birth for SSC to be initiated in the
    1. operating room (OR).
    2. recovery room.
    3. mother's inpatient room.
  5. A third or more of the participants in the study described in this article stated that the baby was assessed by NICU staff for how long after birth and before SSC?
    1. 2 – 4 minutes
    2. 5 – 10 minutes
    3. 15 minutes
  6. A factor that the nurses in this study identified that related to SSC and safety was a concern about the
    1. mother being heavily sedated.
    2. baby not having APGAR scores completed.
    3. OR temperature being too cold for SSC.
  7. The main safety concerns in this study related to
    1. initial assessment of the baby.
    2. a nurse's proximity to the baby.
    3. care of the mother.
  8. According to the Association of Women's Health, Obstetric, and Neonatal Nurses (2010), nurse staffing guidelines at birth include
    1. one nurse for the mother plus baby at every birth.
    2. one nurse for the mother and one nurse for the baby at cesarean births only.
    3. one nurse for the mother and one nurse for the baby at every birth.
  9. The nurses in this study identified which barrier to SSC related to staffing?
    1. inexperienced staff
    2. cost-effectiveness
    3. territoriality of NICU nurses
  10. Logistically, some nurses reported that barriers to SSC after cesarean birth include all of the following except
    1. insufficient time in the OR after the birth.
    2. maternal positioning with the arms extended onto arm boards.
    3. anesthesia provider “ownership” of the head of the OR table.
  11. Potential drivers for practice change identified by the participants included all of the following except
    1. patient satisfaction scores.
    2. a new Joint Commission regulation.
    3. meeting the expectations of the patients and their families.
  12. One nurse shared, “I think the biggest barriers are the providers saying,
    1. ‘We can't do it.’”
    2. ‘Most mothers don't want it.’”
    3. ‘There's no value in it.’”
  13. Performing SSC after cesarean births on a regular basis is important to maintain
    1. a high Leapfrog hospital grade.
    2. Magnet status.
    3. baby-friendly designation.
  14. If the mother is unable to do SSC, some nurses reported that they
    1. gave the birth partners the opportunity to do SSC.
    2. had to abandon the idea of SSC, but only in those instances.
    3. placed the baby in a bassinet next to the mother.
  15. The authors report that the most significant finding in this study was a lack of
    1. documented benefits of SSC.
    2. administrative support for SSC.
    3. formal policies and procedures supporting SSC.
  16. As noted in the article, what did Zwedberg et al. (2015) note was a barrier to the practice of SSC after cesarean birth?
    1. infection control issues in the OR
    2. a lack of education among providers
    3. emergency care needed for the mother or baby
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