Adopting Early Essential Newborn Care (EENC) in the Delivery Room: An Implementation Study From China.

Background: Early Essential Newborn Care (EENC) is a highly beneficial and cost-effective set of evidence-based interventions for newborns and their mothers. However, the implementation of EENC as part of routine clinical practice in the delivery room has not yet been achieved in China. The purpose of this study was to describe the adoption of EENC in general hospitals in China and to evaluate its implementation impacts.

Methods: This study was an implementation study. The design of the implementation process was guided by a Knowledge-to-Action Framework and the conceptual model of implementation research. Mixed methods were used to evaluate the implementation of EENC with qualitative and quantitative data collection methods, including implementation outcomes, service outcomes, and patient outcomes.

Results: A total of 279 patients and 25 nurse-midwives were evaluated in this study. Both the implementation and service outcomes in this study were satisfactory. Obstacles were reported in the acceptability, feasibility, adoption, and fidelity of EENC, such as the acceptance of evidence by nurse-midwives, the support of managers to implement EENC in staff under their management, and the allocation of adequate resources. For patient outcomes, the rates of exclusive breastfeeding during hospitalization (27.1% vs. 39.6%, p < 0.05) and early initiation of breastfeeding (51.4% vs. 64.0%, p < 0.05) improved after EENC was implemented. Furthermore, the amount of vaginal bleeding after 2 h by subjects in the EENC implementation group [(283.92 ± 71.31 mL) vs. (308.78 ± 84.42 mL), t = 2.694, p < 0.05] was also significantly reduced.

Conclusion: EENC can be effectively implemented in general hospitals, but some factors affecting the implementation of EENC included the acceptance of evidence by nurse-midwives, support from managers, and resource allocation. The implementation of EENC was found to be beneficial to newborns and their mothers. Our findings indicate that EENC should be incorporated as part of routine maternity care and nursing practice.