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J Obstet Gynecol Neonatal Nurs. 2018 Nov;47(6):803-811. doi: 10.1016/j.jogn.2018.09.003. Epub 2018 Oct 5.

Implementation of Delayed Cord Clamping in Vigorous Preterm Neonates.

Abstract

OBJECTIVE:

To adopt evidence-based recommendations to delay cord clamping in vigorous preterm neonates.

DESIGN:

Evidence-based practice change project with quantitative data.

SETTING/LOCAL PROBLEM:

Delayed cord clamping (DCC) was not a usual practice at the hospital where this project took place, despite research findings that show benefits of DCC for preterm neonates.

PARTICIPANTS:

Vigorous neonates born before 37 weeks completed gestation.

INTERVENTION/MEASUREMENT:

An interprofessional obstetric team of obstetricians and registered nurses implemented DCC for up to 1 minute for vigorous preterm neonates.

RESULTS:

We found that Apgar scores at 1 minute (mean [M] = 8.35, standard deviation [SD] = .551, n = 31) were statistically significantly higher with DCC than at 1 minute with immediate cord clamping (M = 7.16, SD = 1.834, n = 19) at t (20.008) = 1.197, p = .012. The Apgar scores at 5 minutes (M = 9.00, SD = 0.258, n = 31) were statistically significantly higher with DCC than at 5 minutes with immediate cord clamping (M = 8.58, SD = .838, n = 19) at t (20.116) = 2.130, p = 0.046.

CONCLUSION:

Delayed cord clamping was adopted as a usual clinical practice, and implementation of this practice in vigorous preterm neonates increased their Apgar scores. The obstetric team's awareness, experience, and professional perspectives about DCC improved.

KEYWORDS:

delayed cord clamping; evidence-based practice; quality improvement; vigorous preterm neonates

PMID:
30292775
DOI:
10.1016/j.jogn.2018.09.003
[Indexed for MEDLINE]

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