What is stopping us? An implementation science study of kangaroo care in British Columbia's neonatal intensive care units.

Background: The goal of the Neonatal Intensive Care Unit (NICU) is to provide optimal care for preterm and sick infants while supporting their growth and development. The NICU environment can be stressful for preterm infants and often cannot adequately support their neurodevelopmental needs. Kangaro...

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Publicado en:BMC Pregnancy & Childbirth Vol. 21; no. 1; pp. 1 - 16
Autores principales: Coutts, Sarah, Woldring, Alix, Pederson, Ann, De Salaberry, Julie, Osiovich, Horacio, Brotto, Lori A.
Formato: Journal Article
Publicado: BioMed Central 1/12/2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 1/12/2021
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      pub: BioMed Central
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        10.1186/s12884-020-03488-5
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        atl: What is stopping us? An implementation science study of kangaroo care in British Columbia's neonatal intensive care units.
      aug:
        au:
          Coutts, Sarah
          Woldring, Alix
          Pederson, Ann
          De Salaberry, Julie
          Osiovich, Horacio
          Brotto, Lori A.
        affil: Perinatal Services BC, 260 – 1770 W 7th Ave, V6J 4Y6, Vancouver, BC, Canada
      sug:
        subj:
          Attitude of Health Personnel
          Kangaroo Care
          Intensive Care Units, Neonatal
          Pregnancy
          Interviews
          British Columbia
          Female
          Infant, Newborn
          Short Portable Mental Status Questionnaire
          Scales
          Infant, Newborn: birth-1 month
          Female
      ab: Background: The goal of the Neonatal Intensive Care Unit (NICU) is to provide optimal care for preterm and sick infants while supporting their growth and development. The NICU environment can be stressful for preterm infants and often cannot adequately support their neurodevelopmental needs. Kangaroo Care (KC) is an evidence-based developmental care strategy that has been shown to be associated with improved short and long term neurodevelopmental outcomes for preterm infants. Despite evidence for best practice, uptake of the practice of KC in resource supported settings remains low. The aim of this study was to identify and describe healthcare providers' perspectives on the barriers and enablers of implementing KC.Methods: This qualitative study was set in 11 NICUs in British Columbia, Canada, ranging in size from 6 to 70 beds, with mixed levels of care from the less acute up to the most complex acute neonatal care. A total of 35 semi-structured healthcare provider interviews were conducted to understand their experiences providing KC in the NICU. Data were coded and emerging themes were identified. The Consolidated Framework for Implementation Research (CFIR) guided our research methods.Results: Four overarching themes were identified as barriers and enablers to KC by healthcare providers in their particular setting: 1) the NICU physical environment; 2) healthcare provider beliefs about KC; 3) clinical practice variation; and 4) parent presence. Depending on the specific features of a given site these factors functioned as an enabler or barrier to practicing KC.Conclusions: A 'one size fits all' approach cannot be identified to guide Kangaroo Care implementation as it is a complex intervention and each NICU presents unique barriers and enablers to its uptake. Support for improving parental presence, shifting healthcare provider beliefs, identifying creative solutions to NICU design and space constraints, and the development of a provincial guideline for KC in NICUs may together provide the impetus to change practice and reduce barriers to KC for healthcare providers, families, and administrators at local and system levels.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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