Therapeutic Touch

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Therapeutic Touch

• Kangaroo
• Holding

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Kangaroo Care

• Developing attachment in the NICU
• Skin to skin contact is the most preferred
  intervention to decrease neonatal morbidity and
  mortality
• Short term goal- maintain temperature

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Kangaroo Care

• Began 1980s in Bogata, Columbia
• Practice spreading worldwide because of benefits
• Germany- if baby under 500 grams
• South Africa- opportunity for breastfeeding
• Zimbabwe- mortality reduced 40
• Now practiced in 25 developing countries and many
  industrialized countries

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Pathophysiology

• Benefits to the infant
• Breathe better
• Regulate heart rate- reduces dramatic increases
• Analgesic effect
• Doubles sleep time
• Increased mouthing movements

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Pathophysiology

• Many other benefits
• Improve breast feeding- duration increased by 8
  weeks
• Promotes breastfeeding
• Supports growth and development
• Thermoregulation
• Mother is preferred heat source
• Neutral thermal range with skin contact
• Mother adapts body temp for newborn

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Psychological

• Shown to have positive effects on mother-infant
  bonding, stress reducing for both
• Improves birthing experience for mother and
  father
• Mothers demonstrate more maternal affection
  behaviors
• Provides tactile comfort and verbal interaction
• Enhanced father participation
• Decreases maternal post partum depression

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Womens Health

• Promotes a mothers sense of confidence and
  independence
• Enables woman promote the health and well being
  of her and her child
• Will initiate the bonding pattern
• Most nurses did not view kangaroo care as an
  added burden
• Main goal is support parental confidence and
  competence

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Womens Health

• Nurses need to be there to provide information
  and offer support especially LBW babies
• Fewer nurses needed to assist with normal term
  infants
• Some nurses may feel frustration
• Nurses feel benefits of kangaroo care can result
  in less workload for staff

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Potential Risks and Concerns

• These are intensive care patients with multiple
  precautions noted.
• Nurses often concerned with accidental
  dislodgement of lines, mechanical ventilation,
  etc.
• Required monitoring and appropriate education for
  both mother and father
• Education of the benefits of kangaroo care is a
  pivotal role for the nurse providing care
• Nurse self-awareness regarding kangaroo care

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Interventions

• Immediate skin to skin contact with mother post
  delivery
• Dry baby put on hat and diaper, place on mother
  with warm blanket
• Obtain APGAR scores, place I.D. bands
• Vit K and Erythromycin after feeding
• Other assessments after feeding

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Interventions

• Skin to skin contact for first 24 hours of life
  and beyond
• Minimize tasks that remove baby from mother
  immediately after birth

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Nursing Implications

• Promote education, parent teaching
• Effortless and no cost considerations
• Consider condition of infant
• Staff assistance to prevent dislodging infusion
  lines
• Organizational support- guidelines and protocols

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Nursing Implications

• Nurse educator-
• teaching principles in prenatal classes
• Discuss fundamental role
• Use of visual aids, reading materials
• Discussion board, phone call follow-up
• Nursery nurse-
• Front line educators
• Adequate rest and pain management
• Documentation on discharge paperwork

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Nursing Implications

• Pediatric nurse-
• In-service on kangaroo care
• Modifications to environment
• Community health nurse-
• Required in order to take practice beyond the
  NICU

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References

• Chia, P. (2006). The Attitudes and Practices of
  Neonatal Nurses in the use of Kangaroo Care.
  Australian Journal of Advanced Nursing , 20-27.
• Johnson, A. N. (2005). Kangaroo Holding Beyond
  the NICU. Pediatric Nursing , 53-56.
• Kostandy, R., Ludington-Hoe, S., Cong, X.
  (2008). Kangaroo Care (Skin Contact) Reduces
  Crying
• Response to Pain in Preterm Neonates Pilot
  Results. Medscape , 55-65.
•  Images
• www.digitalfieldguide.com/blog/page/35
• http//graphics.iparenting.com/clipart/newfamily/E
  009344L.JPG
• www.adnb.govt.nz/.../KangarooCare.htm
• http//moosekisspress.com/synopsis.html