An intervention to decrease time to parents' first hold of infants in the Neonatal Intensive Care Unit requiring respiratory support.

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%. Lean Six Sigma methodology was used to identify barriers to holding and opportunities for improvement. A multifactorial improvement bundle was implemented to reduce the time to first parental hold of critically ill neonates. 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. Implementation of an improvement bundle resulted in a significant reduction in time to first parental hold of infants requiring respiratory support.