pre-SUCCECS: Lessons learned from implementing resuscitation and stabilisation with an intact cord during caesarean sections – Focus group discussions with implementation teams

Objective

The primary aim of this study was to explore the lessons learned from implementing a procedure of resuscitation and stabilization with an intact umbilical cord for preterm and term infants requiring resuscitation or stabilization during emergency caesarean sections.

Methods

Data were collected by two focus group discussions and one individual interview. Participants were members of implementation teams responsible for implementing of resuscitation and stabilization with an intact cord during caesarean sections. The implementation teams were from two hospitals from different metropolitan areas in Sweden. We used a deductive approach with data collection and analysis guided by the Consolidated Framework for Implementation Research 2.0 and an inductive approach to derive lessons learned.

Results

All implementation domains except the outer setting were represented in the results. Suggested solutions to common concerns such as maintaining sterility, temperature control of the neonate and availability of the equipment were described by the implementation teams. Additionally, the participants highlighted the importance of a multidisciplinary implementation team with all professions represented as well the need for decision-making authority in the team, for successful implementation.

Conclusions

The lessons learned from implementing neonatal resuscitation and stabilisation with an intact umbilical cord during caesarean section can inform efficient strategies for implementing this complex intervention into clinical routines across difverse birth settings.

Synopsis

Lessons learned from implementing resuscitation and stabilization with an intact cord during emergency caesarean sections are included. Possible solutions to concerns about sterility, neonatal temperature control, and equipment availability are presented.