Abstract
International research acknowledges that there are multi-dimensional factors that affect the implementation of kangaroo care in the neonatal intensive care unit. While it is accepted that the nurse plays an important role in stimulating the implementation of kangaroo care, its success as a neonatal care strategy pivots on infant readiness, parental readiness and parental availability. In addition, interprofessional collaboration and teamwork are necessary for safe implementation. Kangaroo care is a simple and cost-effective health strategy that has well documented effects for its contribution towards improving well-being and health outcomes for premature babies and their parents. Its benefits when applied to preterm babies in the neonatal intensive care are immediate and cumulative. Importantly research has shown that the benefits and implications of kangaroo care for health go beyond the neonatal intensive care.
However, little is known about New Zealand registered nurses’: experiences of their role in the implementation of kangaroo care; knowledge of the underpinning evidence supporting the therapeutic value of kangaroo care for premature babies; and current level of practice of kangaroo care.
Aim: The aim of this study was to explore registered nurses’ experiences, knowledge and practice of kangaroo care and to highlight factors that promote or hinder the uptake of kangaroo care for preterm babies in two neonatal intensive care units in New Zealand.
Methods: Using a purposive sampling strategy, 14 registered nurses, who met the inclusion criteria, participated. This was a qualitative, semi-structured interview-based study. The participants guided the flow of the interviews. Inductive thematic analysis, as outlined by Braun and Clarke, allowed for rich-description and interpretation of the participant-generated meanings. Coded data was grouped into themes and sub-themes.
Results: Four main themes were generated from the data. Importantly the findings from this study highlighted that nurses in New Zealand know about kangaroo care and use it in everyday clinical practice. The snapshots of clinical practice provided by the nurses strengthened what is known about the effects of kangaroo care on the baby and the parents. The nurses made it apparent that applying kangaroo care was implicit in the ICU when babies were most likely to be at a critical phase in their development and recovery.
Most of the nurses named the lack of standardisation of practice and out-dated nursing practice mind-sets as influential to the variable implementation of daily kangaroo care for the growing preterm baby. Half of the nurses highlighted that staffing, heavy workloads, the busy, crowded, and noisy environment of less acute areas were influential to the limited practice of kangaroo care for stable growing preterm babies.
Conclusion: This study identified organisational support for the practice of kangaroo care in the neonatal intensive care unit. Also, that kangaroo care was being implemented, albeit irregularly. It established that facilitating parental readiness, affording clear local practice guidelines, providing continuing education initiatives for staff as well as parents may invigorate the practice of kangaroo care within the neonatal intensive care unit.