Examination of the implementation determinants of skin-to-skin care in the pediatric cardiac Intensive Care Unit.

Skin-to-skin care (SSC), where parents hold their unclothed baby directly on their bare chest, is regarded as best practice for hospitalized infants. SSC is not routine for infants with complex congenital heart disease (cCHD) in the Pediatric Cardiac Intensive Care Unit (PCICU). SSC is understudied...

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Publicado en:Journal of Pediatric Nursing Vol. 85; pp. 321 - 332
Autores principales: Lisanti, Amy Jo, Demianczyk, Abigail C., Whittaker, Jennifer, Nag, Diya, Kellom, Katherine, Brennan, Claire, Hayden-Rush, Christina, Herrup, Elizabeth A., Grabill, Megan, O'Brien, Caroline, Min, Jungwon, Bettencourt, Amanda P.
Formato: research Journal Article
Publicado: W B Saunders Nov2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2025
      vid: 85
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      pub: W B Saunders
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        10.1016/j.pedn.2025.08.008
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        atl: Examination of the implementation determinants of skin-to-skin care in the pediatric cardiac Intensive Care Unit.
      aug:
        au:
          Lisanti, Amy Jo
          Demianczyk, Abigail C.
          Whittaker, Jennifer
          Nag, Diya
          Kellom, Katherine
          Brennan, Claire
          Hayden-Rush, Christina
          Herrup, Elizabeth A.
          Grabill, Megan
          O'Brien, Caroline
          Min, Jungwon
          Bettencourt, Amanda P.
        affil: Department of Family and Community Health, School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, PA 19104, United States of America
      sug:
        subj:
          Kangaroo Care
          Implementation Science
          Health Services Accessibility
          Coronary Care Units
          Intensive Care Units, Pediatric
          Human
          Heart Defects, Congenital
          Cardiac Patients
          Infant, Hospitalized
          Inpatients
          Multicenter Studies
          Multimethod Studies
          Conceptual Framework
          Interviews
          United States
          Purposive Sample
          Snowball Sample
          Thematic Analysis
          Descriptive Statistics
          Content Analysis
          Summated Rating Scaling
          Professional Knowledge
          Communication
          Professional Role
          Patient Safety
          Attitude of Health Personnel
      ab: Skin-to-skin care (SSC), where parents hold their unclothed baby directly on their bare chest, is regarded as best practice for hospitalized infants. SSC is not routine for infants with complex congenital heart disease (cCHD) in the Pediatric Cardiac Intensive Care Unit (PCICU). SSC is understudied and the contextual factors influencing its implementation in the PCICU are unknown. This multisite, multi-methods study using the Tailored Implementation for Chronic Diseases implementation determinants framework aimed to identify the contextual factors influencing the implementation of SSC in the PCICU. We interviewed stakeholders across two US PCICUs, one with previous implementation experience of SSC and one with little to no implementation experience. We used purposive snowball sampling, representing the interdisciplinary team of clinicians (n = 25) and parents (n = 21) at each site, until we reached thematic saturation. Clinicians completed a suite of valid and reliable surveys of acceptability, feasibility, and appropriateness. Descriptive statistics were calculated for the acceptability, feasibility, and appropriateness measures, with comparative analysis across clinician characteristics. Cross-cutting key themes were generated from a combined inductive and deductive approach to content analysis. On a five-point Likert scale, clinicians rated their acceptability (mean = 4.7, SD = 0.4), feasibility (mean = 4.2, SD = 0.7), and appropriateness (mean = 4.5, SD = 0.5) of SSC in the PCICU within the agree/completely agree range. Cross-cutting themes included knowledge, communication, role clarity, resources, and safety. Findings will be the foundation for implementation mapping, where identified barriers and facilitators are linked with evidence-based implementation strategies that can be tested to enhance the implementation of SSC in the PCICU. • Skin-to-skin care is underutilized in US pediatric cardiac intensive care units. • Barriers and facilitators to the implementation of skin-to-skin care were identified. • Clinicians perceive skin-to-skin care to be acceptable, feasible, and appropriate. • Implementation science methods may address current practice gaps.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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