The self-efficacy of counselors providing telemental health services during the Covid-19 pandemic

Since the onset of the COVID-19 pandemic, counselors have had to adapt and evolve to meet the needs of clients and the growing need for mental health services. In addition to a lack of experience providing telemental health (TMH) services, many counselors had received little or no TMH training or continuing education prior to the onset of the COVID-19 pandemic. Counselor self-efficacy (CSE) may be an important factor in determining how counselors have been impacted by the increase in provision of TMH services, and the areas where they are needing more support. The purpose of this quantitative study was to explore how the amount TMH training and continuing education received, the amount of time spent providing TMH services, and the amount of time spent providing counseling services predict CSE. Participants (n=84) completed an online survey containing items from the Counseling Self-Estimate Inventory (COSE). Results of a bivariate regression and one-way ANOVA indicated that TMH training and continuing education did not predict CSE;however, differences between groups revealed an interesting phenomenon which prompted further discussion. Results also showed that both the amount of time spent providing TMH services and the amount of time spent providing counseling services predicted CSE. Counselors and counselor educators can use results from this study to advocate for more resources and support for counseling students and counselors who are providing TMH services. Furthermore, results from this study indicate a need for more research on CSE and TMH to improve counselor education and support. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The school counselor's role in a post-COVID-19 era

In March 2020, COVID-19 caused many schools worldwide to unexpectedly end their academic year early. Some schools attempted to transition in what seemed almost overnight from traditional face-to-face delivery to remote online delivery. Remote delivery did not always mean an online delivery, but in most cases, online technology was heavily depended upon. This paper specifically looked at the role and tasks of the school counselor when students were not able to be physically located within the school building. The paper attempts to answer the question of how school counselors can effectively develop and deliver their comprehensive programs to all students during emergency closures. Initial challenges and issues highlighted by the school closure will be explored, as well as issues to consider for school counselors as schools prepare to reopen. © Springer Nature Switzerland AG 2021. All rights reserved.

Experiences of Counselors Who Provided Psychological Support during COVID-19 Disaster: A Qualitative Study

Background: In crisis intervention sites such as infectious disease disasters, counselors are repeatedly exposed, directly or indirectly, to the traumatic experiences of victims. Disaster counseling has a negative effect on coun-selors, which can eventually interfere with the counseling process for disaster victims. Therefore, exploring and understanding the experiences of counselors is necessary to ensure that qualitative counseling for disaster victims can be continuously and efficiently conducted. Objectives: This study investigated the experiences of counselors who participated in mental health counseling as psychological support for victims of the COVID-19 disaster in Korea. Design: This is a qualitative study. Participants: The study participants comprised 18 counselors who had mental health professional qualifications of level 2 or higher and who had provided mental health counseling for COVID-19 confirmed cases and quarantined persons. Methods: Data were collected using focus group interviews from February 21 to May 29, 2021. The duration of each interview was 60-90 min, and the data were analyzed using content analysis. Results: The final theme was "Continuing to walk this road anytime, anywhere." The par-ticipants' experiences were identified in four sub-themes: "being deployed to unprepared counseling," "encoun-tering various difficulties," "feeling full of meaning and value," and "hoping to become a better counselor." Conclusions: In order to continuously provide qualitative counseling in case of an infectious disease disaster such as COVID-19, it is important to develop a qualification and competency strengthening program through educa-tion and training to secure the crisis intervention expertise of counselors according to the characteristics of the disaster. In addition, a psychological support manual for each disaster should be prepared at the national level according to the type of disaster.

Understanding and Addressing the Well-Being of School Counselors

Diminished self-care practices and heightened stress of school counselors are continuing problems in education. With role ambiguity, high student-to-counselor ratios, emotional exhaustion, and other factors adding pressure to the roles and responsibilities of school counselors, this study investigated the well-being practiced of Missouri school counselors and the internal and external factors which influence them. Findings demonstrate several ways in which school counselors fail to meet basic well-being benchmarks, examples of positive school principal supports, and systemic counselor role ambiguity, mission creep, and high caseloads that contribute to stress and burnout. These results indicate three levels of decision-making that are paramount to school counselors achieving and sustaining healthy well-being practices--the individual counselor's role in self-care and professional advocacy;the school leader's approach to defining the counselor's role and promoting a healthy workplace culture;and the ways in which policymakers affect systemic change.

Counselor educator workload and burnout in the era of covid-19

The COVID-19 pandemic brought disruption to teaching and other aspects of workload in higher education. The current study sampled 126 counselor educators about workload, compassion satisfaction, burnout, and job satisfaction. Results indicated that faculty workload and administrative responsibilities increased for counselor educators during the pandemic without adequate compensation or support. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Experiences and preferences of Healthcare Professionals using telegenetics in a UK Clinical Genetics centre during the COVID-19 pandemic

Background/Objectives: The changes and restrictions precipitated by the COVID-19 pandemic have led to innovation in Clinical Genetics service delivery worldwide. At the Guy's and St Thomas' (GSTT) Clinical Genetics Service, telegenetics was implemented at the beginning of the pandemic using the AttendAnywhere videoconferencing platform. We subsequently designed a qualitative study to capture experiences and preferences of Healthcare Professional's (HCP) using this service delivery model. Method(s): We conducted semi-structured interviews with seven HCPs working at the GSTT Clinical Genetics Service, including Genetic Counsellors, Clinical Geneticists and a Clinical Psychologist. Interview content was analysed using a thematic analysis approach. Result(s): We present HCPs' experiences of transitioning between virtual and in-person appointments and their appraisal of the technical and practical aspects of telegenetics. We also present themes that emerged about how HCPs' clinical practice has changed to adapt to telegenetics, as well as differences in both patients' and HCPs' attitudes towards virtual appointments when compared to in-person encounters. Future considerations will be shared regarding the suitability of telegenetics for Clinical Genetics appointments. Conclusion(s): Based on their experience at GSTT, HCPs interviewed would welcome the addition of telegenetics to the Clinical Genetics toolkit beyond the COVID-19 pandemic, and we will provide considerations for future guidelines.

Life Balance and Work Addiction among School Counselors at the Onset of the COVID-19 Pandemic

Life balance is prioritizing work and personal life to create a meaningful, quality lifestyle. Work addiction is overworking at the expense of life balance. COVID-19 disrupted K-12 schools and counseling delivery services nationwide. Like many other front-line helping professionals, school counselors responded to the complex and challenging work conditions created by the COVID-19 pandemic. The authors examined life balance and work addiction among 145 practicing school counselors nationwide. The results of a multiple regression analysis examined the extent to which stress/anxiety and sleep disturbance predicted work addiction. We discuss the findings in light of practice and research. [ FROM AUTHOR] Copyright of Journal of Professional Counseling: Practice, Theory & Research is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

An Rct of Home-Based Care to Reduce Posthospital Mortality in South Africa: Homelink

Background: In sub-Saharan Africa 23% of people living with HIV (PLWH) die 6 months after discharge from a hospital. Failure to engage in care posthospitalization is associated with mortality. We evaluated whether a series of structured post-hospitalization home visits would reduce mortality among recently discharged PLHIV in South Africa. Method(s): We designed a home visit package with up to 6 home visits starting 1-week post-hospitalization and every 2 weeks as required thereafter. The home visit team consisted of a professional nurse and a counsellor;they used a structured assessment algorithm to evaluate participants' social and medical needs, obtained direction from a doctor for further guidance, collected specimens for laboratory testing, or referred the participant for further evaluation. We compared this intervention to care as usual in a pilot randomized trial conducted at a single hospital in South Africa. The primary goals of the study were to determine feasibility and acceptability and identify opportunities to improve the home visit intervention. We report effectiveness for PLWH based on the primary outcome of all-cause mortality 6 months after discharge from hospital. Result(s): We enrolled 125 PLWH who were randomized 1:1 to home visit intervention or care as usual;14 were late exclusions because they died prior to discharge (n=13) or had a prolonged hospital stay (n=1). In the 111 PLHIV included in the analysis, the median (interquartile range [IQR]) age was 39 (33, 48) years, 69% were women, the median duration of the index hospitalization was 7 (3, 12) days, and primary reasons for the index hospitalization included TB (31%), heart and/or lung related diseases (22%), non-TB/COVID infections (25%), and anemia (15%). Most [96% (n=53/55)] intervention arm participants received >=1 home visits. By six months 14 (13%) participants died: 4 (7%) in home visit intervention arm and 10 (18%) in the care as usual arm (p=0.09). A similar proportion of readmissions occurred by arm: 20 (36%) in the home visit arm and 22 (39%) in care as usual. Conclusion(s): Home visits done after discharge from hospital provided care services to an extremely vulnerable group of PLWH at very high mortality risk . We demonstrated both feasibility and preliminary efficacy of delivering post-hospital visits. Structured home visits appear to be a promising approach that would benefit PLWH. Larger studies in diverse populations with cost effectiveness components are required.

Intervention Efficacy on Covid-19 Testing and Vaccination in People Who Inject Drugs

Background: People who inject drugs (PWID) are vulnerable to SARS-CoV-2 and severe disease but have low rates of COVID-19 testing and vaccination due to multilevel barriers. We partnered with a mobile syringe service program (SSP) in San Diego County, CA, to develop the theory-informed LinkUP intervention to increase COVID-19 testing and vaccination among PWID. Method(s): From March-June 2022, we conducted a pilot randomized controlled trial (RCT;ClinicalTrials.gov #NCT05181657) to assess efficacy of LinkUP vs. a didactic attention-matched control condition in increasing COVID-19 testing uptake and acceptance of vaccination referrals. Based on Social Cognitive Theory, trained, SSP-hired peer counsellors delivered tailored education, motivational interviewing, and problem-solving and planning to the active LinkUP intervention arm. We referred eligible participants (PWID, >=18 years old, San Diego County residents without recent voluntary COVID-19 testing or fully vaccinated status) to mobile SSP sites that had been randomized by week to offer LinkUP or the control condition;all participants were then offered on-site rapid COVID-19 antigen testing and vaccination referrals. Our intent-to-treat analysis used Chi-square tests to compare intervention groups' outcomes and log-binomial regression to estimate preliminary intervention efficacy and explore potential moderation. Result(s): Among 150 participants, median age was 41 years, 33% identified as Latinx and 65% as male, 73% were experiencing homelessness, and 45% had prior mandatory COVID-19 testing. Overall, we only detected one SARS-CoV-2 case. However, more active intervention vs. control participants agreed to COVID-19 testing (77.3% vs. 22.7%;p< .001) and vaccine referrals (32.4% vs. 13.3%;p=0.006). Homelessness moderated intervention effects: LinkUP increased COVID-19 testing uptake more among participants experiencing homelessness (adjusted risk ratio [aRR]: 1.64;95% CI: 1.27-2.12) than those not experiencing homelessness (aRR: 1.25;95% CI: 0.99-1.56). Conclusion(s): Findings from this RCT support the efficacy of LinkUP in increasing COVID-19 testing and acceptance of vaccination referrals among PWID presenting at mobile SSP sites, particularly for those experiencing homelessness. This research underscores the significance of communityacademic partnerships when working with PWID and identifies a promising model that could be adapted to increase access to other underutilized vaccines in this vulnerable population.

Development of an overdue outreach program to improve adherence to PKU management

Background: Phenylketonuria (PKU) is an inherited autosomal recessive disorder caused by variants in the PAH gene which encodes for phenylalanine hydroxylase (PAH). PKU, left untreated, can cause intellectual disability, psychiatric symptoms, and behavioral abnormalities. Lifelong management of PKU is challenging, and many adult patients become lost to follow-up, despite recommendations for lifelong management. Method(s): The PKU clinic team is a multidisciplinary team consisting of an APN Director, physician, dieticians, diet tech, genetic counselor, registered nurse, and social worker. After establishing formal guidelines, algorithms were created to determine thresholds for initiating patient outreach based on both age and type of PKU treatment. EMRbased data collection is used to track adherence to both clinic visits and consistent submission of Phe levels. Data was collected and analyzed for roughly 250 PKU patients. Baseline levels for adherence to clinic visits and filter card submission were collected at time of implementation. Data was then reviewed after 18 months, and has been further analyzed for a second 18 months (which correlates with the start of the COVID-19 pandemic) Results: Overall baseline adherence across the population for annual clinic visitswas 72% (144/200). Clinic visit adherence increased to 88% at 18 months, and then was similar at 86% through COVID-19 pandemic. In the adult population, 54% (57/106) were adherent at baseline with clinic follow-up. With implementation compliance increased to 80% initially and was then reported to be 74% during the pandemic. Baseline for all PKU patients showed 81% (161/200) filter card submission within the last 12 months. Submission increased to 91% after 18 months of overdue outreach, and as of October 2021, 85% of all patients had submitted a filter card within the last calendar year. Adult patients specifically showed an increase, with 53% at baseline to 69% after implementation. Conclusion(s): Implementation of an overdue outreach program is successful in re-engaging patients with the PKU clinic and improving adherence to treatment recommendations. We have seen increased patient adherence across all domains and have maintained this improved adherence despite the global COVID-19 pandemic.Copyright © 2022 Elsevier Inc. All rights reserved.

School counselors' early pandemic perceptions and experiences

I initially designed this study to explore the experiences and perceptions of recently credentialed school counselors adjusting to their new professional responsibilities. COVID-19 caused school closures after my data gathering had begun. I followed the original semi-structured interview protocol except I intentionally probed COVID-related topics introduced by participants. Because it also became impossible to recruit participants who met the original criteria of "new" school counselors, I relaxed these criteria to secure eleven participants. The participants described what drew them to the profession, what they most appreciated about their graduate school experiences, how they negotiated the sudden changes, and the joy and satisfaction of serving children's needs. The most vivid outcome is a real-time description of the day-to-day challenges of doing their best under circumstances that one had imagined possible or prepared for. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

A phenomenological investigation of the lived experiences of middle school professional school counselors in addressing student mental health, during the COVID-19 pandemic, after a return to in-person instruction

This study is positioned to contribute to our growing understanding of how COVID-19 has impacted our students and the individuals tasked with promoting their mental health and wellness. The overarching aim was to understand the lived experiences of middle school professional school counselors (PSCs) in addressing student mental health, during the COVID-19 pandemic, after a return to in-person instruction. The study strived to learn, if and how, the PSC's role has changed since returning to in-person instruction and to gauge the kind of support, if any, that they received with their counseling program. The researcher utilized convenience sampling from the Counselor Education and Supervision NETwork-Listserv, the American School Counselor Association listserv and Facebook. The study involved interviews with 10 participants who were employed as a middle school PSC, served in at least the fourth year as a PSC, held a master's degree in counseling, and had internet access. The researcher used Giorgi's descriptive method of phenomenology to analyze the data, which yielded three themes and three subthemes: 1) Awareness and Psychoeducation on the Mental Health Impact of COVID-19, 2) Adapting to Meet the Needs of Students (Utilizing Innovation;Structure and Intention with Direct Service Delivery;Shift to Reactive Services), and 3) Emotional Impact of Being a Helper During the Pandemic. The findings provide stakeholders, PSCs, and school counselor educators with a deeper understanding of factors related to addressing student mental health after a return to in-person instruction and how to better support PSCs in addressing these mental health concerns. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The development of therapeutic relationships during the pandemic: Perceptions of professional counselors using telemental health apps in rural areas

During the COVID-19 pandemic, it became increasingly important to understand how licensed professional counselors used telemental health applications (apps) to establish therapeutic relationships in rural areas. In the past decade, technology has undergone significant changes in its purpose and design. During the COVID-19 pandemic, telemental health was a tool that provided access to mental health services by developing and sharing innovative and effective treatments. The literature suggested that telemental health apps are effective for providing counseling services to clients living in rural areas. Therefore, this technology provided added support to individuals who faced treatment barriers. In this generic qualitative study, data were collected and analyzed regarding the perceptions of therapeutic relationship development among licensed professional counselors using telemental health apps in rural areas during the COVID-19 pandemic. The data collected from the semi-structured interview were analyzed using inductive analysis, through which six themes emerged: (a) relational components of therapy, b) methods and approaches used to guide sessions, (c) client concerns about ethical and privacy issues, (d) barriers to engaging clients in the sessions, (e) the value of videoconferencing platforms to help connect with clients, and (f) evolving new roles and responsibilities. The themes that emerged helped answer the research question: "How have professional counselors used telemental health apps in rural areas to develop the therapeutic relationship during COVID-19?" Counselors may better understand, empathize, support, engage, connect, and develop therapeutic relationships with clients when utilizing these applications. In future research, it would be worthwhile to examine clients' viewpoints, since telemental health applications are designed with clients in mind. Also, associate-level professionals used telemental health to work with clients, and this experience may be useful to gain a perspective from counselors in training. Finally, when it comes to participation recruitment, it may be beneficial to reach out to various social networks, Listservs, and other professional organizations. Counselors may report different experiences regarding their engagement with clients. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Walk and Talk Bereavement Support: Piloting an Innovative Service at Marie Curie Northern Ireland

Introduction At the advent of COVID-19 the bereavement support service in Belfast Hospice had to quickly adapt to new ways of working to ensure continued service provision, with counsellors transitioning to video-link platforms and telephone to facilitate client sessions. However, counsellors reported challenges building a rapport with clients online, and had concerns that the client's grief was compounded by loneliness and social isolation. In response, the Marie Curie walk and walk bereavement support project, in partnership with the National Trust, was proposed as an innovative solution. Taking traditional counselling sessions outdoors meant the counsellors could maintain adherence to COVID-19 guidance, while supporting the mental health and wellbeing of bereaved clients. Furthermore, nature therapy has been shown to enhance both physical and mental health, reducing symptoms of depression. Whilst there are studies that demonstrate the benefit of nature therapy for mental health outcomes, research is limited in bereavement care. Aims Supporting the mental health and wellbeing of bereaved clients. Methods A pilot Walk and Talk bereavement therapy brings together the skilful, compassionate counselling work of Marie Curie staff and volunteers in beautiful, restorative National Trust spaces. We plan to conduct semi-structured interviews with service users to explore their experience of walk and talk therapy. Results To date, the feedback received has been overwhelmingly positive, this is based on informal verbal feedback gathered by counsellors at the end of each session. Conclusions Despite the physical distancing barriers faced during COVID-19, staff and volunteers were able to overcome these challenges through innovation, creativity, and flexibility, to provide person-centred, compassionate bereavement care and support Impact Work is ongoing, but we hope to continue to develop the walk and talk bereavement service with the National Trust, to support the mental and physical health and wellbeing of people affected by dying, death and bereavement.

Exploring Clinician Attitudes Towards Treating Eating Disorders: Bridging Counselor Training Gaps

Eating disorder (ED) clinicians may face various challenges in practice, including burnout and feelings of incompetence. Several deficits may contribute to these challenges, such as graduate education and treatment gaps. In this study, 109 interdisciplinary clinicians were surveyed regarding their personal attitudes, experiences, and challenges in treating EDs. Among the various results, quantitative and qualitative findings highlighted the lack of graduate education as the primary challenge to effectively treating EDs, as well as the need for more ED research and culturally responsive care. Recommendations to enhance ED education and counselor training are provided, including managing countertransference and advocating for specialized coursework. Lastly, critical directions for future research are discussed.

Care and support for the covid - 19 bereaved family members: The counselor's role

Worldwide, COVID-19 outbreak has been impacting people. The death toll from Covid-19 has reached 57,50,868 globally, with 39,72,59,234 verified cases. In India, there are 4,24,10,976 confirmed cases of COVID-19, and the death toll has risen to 5,05,279. Everyone experiences bereavement at some point during their lifetime. It is a universal sensation. Many find that when they adjust and integrate their loss into their daily life, their level of sadness lessens over time. The grievers or carers may go through deep, persistent, and crippling grief that satisfies the DSM V criteria for Prolonged Grief Condition, a recognised mental disorder. The majority of people adjust after a loss, with two-thirds saying that their financial, emotional, and physical conditions remained unchanged. Severe dyspnea, patient seclusion, visitation limitations, death in intensive care units, anguish of patients/family members, and disruption of relatives' social support networks are the mourning risk factors. The following psychological interventions will be used in this study to attempt to illustrate the treatment, emotional support, and counselling available to bereaved family members and caregivers (Cognitive Behavior Therapy, Acceptance and Commitment Therapy, Art based therapy, Group Therapy, Traumatic Grief Therapy, Complicated Grief Therapy).Copyright © 2023, Anka Publishers. All rights reserved.

Cyber racism in counseling cyberspaces

Attention toward how technology may be used to perpetuate racism is warranted given the global impact of the COVID-19 pandemic. We examined cyberspaces associated with the counseling profession to estimate the prevalence and impact of cyber racism using a cross-sectional design. Results indicated that exposure to cyber racism may impact emotions and perceived inclusion in groups. Dado el impacto global de la pandemia por COVID-19, es pertinente prestar atención a cómo la tecnología puede ser usada para perpetuar el racismo. Examinamos ciberespacios asociados con la profesión de la consejería para estimar la prevalencia e impacto del racismo en internet usando un diseño transversal. Los resultados indicaron que la exposición al racismo en internet puede tener un impacto sobre las emociones y la percepción de inclusión en grupos. © 2023 by the American Counseling Association.

Developing a partnership for internship training at a community-based animal assisted therapy practice

The effectiveness of a pre-graduation animal assisted therapy internship site was investigated through an ethnographic, phenomenological methodology with mixed-methods components. A total of 12 participants who fit into either the category of supervisor, intern, or administrator involved in the animal assisted therapy practice, were interviewed. A research team analyzed the qualitative interview data and researcher participant field notes and came to a consensus of eight major themes: ranch environment, ranch modalities, community impact, counselor development, relationships, partnership, sense of purpose, and the COVID-19 pandemic. Past historical client data were analyzed (n = 47) to investigate effectiveness of the AAT internship cite through the lens of the clients. Historical client data was divided into three categories, dependent on the client's age and the assessment taken: Adult Self Report (ASR), Youth Self Report (YSR), and Child Behavior Checklist (CBCL). A paired t-test was run for each assessment group to compare the means of the pre-assessment scores and the means of the post assessment scores for the total problems scale and anxiety problems scale. There was a statistically significant decrease in anxiety problems for the CBCL group. There was a marginally statistically significant decrease in total problems for the CBCL group. There were no significant results found for the YSR or ASR data. Client demographic findings and the statistically significant findings are discussed in relation to the qualitative themes. Implications for future research and counselor education are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Phenomenological study of the impact of COVID-19 on graduate counseling students

With the declaration of a pandemic in March 2020, unprecedented changes have occurred globally to mitigate the impact of COVID-19. This phenomenological qualitative study sought to understand the lived experiences of graduate counseling students at an Atlantic Canadian university as they were navigating the pandemic. The study also sought to explore the impact on their developing professional counseling identity and the adaptive processes that may provide insight into the participants' overall resilience in the face of crisis. Through semi-structured interviews with 15 participants, the following research questions were explored: What are the lived experiences of graduate counseling students during the COVID-19 pandemic;how do graduate counseling students perceive the impact of the pandemic on their professional identity;and how do graduate counseling students perceive their resilience and employ protective factors during the pandemic? Using the theoretical frameworks of Communities of Practice, family systems, and Family Resilience Framework, data was analyzed, and the following themes emerged from participants' responses to the research questions: impact on student well-being, impact on student learning, development of professional self, integration into the profession, cohort community of practice, meaning-making, positive outlook, and transformative growth. The findings of this study have implications for the development of the professional counseling identity and preservice counselor wellness in counselor education programs. Ongoing research is needed around the continuing preparation of preservice counselors for the profession's changing landscape. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

A Quality Improvement Initiative on sustaining Kangaroo Mother Care Practices During COVID Pandemic

Introduction: COVID-19 pandemic has affected the KMC practices in our SNCU. Lack of clear guidelines and training about continuing KMC in COVID-19 times has further lead to decrease in KMC practices. Method(s): This is a prospective single centered quality improvement study conducted in the inborn unit of a tertiary care hospital. Intervention phase was done in August and September 2020. Preterm mother-infant dyads who were admitted in the inborn Level 2 Neonatal care unit with birth weight less than 2000 grams were enrolled in this study. A QI team comprising of resident doctors, nurses and supporting staff and a lactation counsellor was formed. The potential barriers for prolonged KMC were evaluated using fish bone analysis. A variety of measures were introduced and subsequently tested by seven plan-do-study-act (PDSA) cycles. Data on percentage of initiation of KMC was measured by bedside nurses on daily basis and the data was plotted on run chart every week during implementation phase. Result(s): 116 eligible mother-infant dyads were studied during implementation period (50 days). We achieved our goal by step-wise implementation of changes through multiple PDSA cycles. The percentage of initiation of KMC among eligible preterm infants has increased from baseline of 43.4% to 83.3% and duration of KMC from 1.5 mean hours to 4.5 hours over a period of eight weeks. Conclusion(s): Ongoing quality improvement measures increased the percentage of initiation and duration of KMC among eligible preterm infants without addition of extra man power.Copyright © 2022 by author(s). This is an Open Access article distributed under Creative Commons Attribution License (CC BY NC ).