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. 2021 Jan 12;21(1):52.
doi: 10.1186/s12884-020-03488-5.

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

Sarah Coutts  1 , Alix Woldring  2 , Ann Pederson  2   3   4 , Julie De Salaberry  3 , Horacio Osiovich  3   4 , Lori A Brotto  5   6
Affiliations

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

Sarah Coutts et al. BMC Pregnancy Childbirth. .

Abstract

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.

Keywords: Canada; Family-centered care; Implementation science; Kangaroo care; Kangaroo mother care; Neonatal intensive care unit; Neurodevelopment.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Map of British Columbia and geographical location of NICUs
See this image and copyright information in PMC

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References

    1. Altimier L, Phillips RM. The neonatal integrative developmental care model: seven Neuroprotective Core measures for family-centered developmental care. Newborn Infant Nurs Rev. 2013;13(1):9–22. doi: 10.1053/j.nainr.2012.12.002. - DOI
    1. Head LM. The effect of kangaroo care on neurodevelopmental outcomes in preterm infants. J perinatand neonatal nurs. 2014;28(4):290–9. - PubMed
    1. Lassi ZS, Middleton PF, Crowther C, Bhutta ZA. Interventions to improve neonatal Health and later survival: an overview of systematic Reviews. EBioMedicine. 2015;2(8):985–1000. doi: 10.1016/j.ebiom.2015.05.023. - DOI - PMC - PubMed
    1. te Pas AB. Improving neonatal care with technology. Frontiers in Pediatrics. 2017;5(110):1–3. 10.3389/fped.2017.00110. - PMC - PubMed
    1. Stoll BJ, Hansen NI, Bell EF, Shankaran S, Laptook AR, Walsh MC, et al. Neonatal outcomes of extremely preterm infants from the NICHD neonatal research network. Pediatrics. 2010;126(3):443–456. doi: 10.1542/peds.2009-2959. - DOI - PMC - PubMed

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