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Published on: August 25, 2014
Close to me: enhancing kangaroo care practice for NICU staff and parents
Liza Cooper1, Allison Morrill, Rebecca B Russell
1Child and Family Education, the Center for Child and Family Experience, Sala Institute for Child and Family-Centered Care at NYU Langone Medical Center, New York (Ms Cooper); Perinatal Data Center, Program Resource Development and Evaluation Department (Ms Russell), Signature Programs, Chapter Programs Department (Ms Gooding), NICU Initiatives, Chapter Programs Department (Ms Miller), and Chapter Programs Department (Dr Berns), March of Dimes Foundation, White Plains, New York; and School of Community and Population Health, University of New England, Portland, Maine (Dr Morrill).
Purpose:
The benefits of kangaroo care (KC) are well supported by previously published studies, yet KC is offered inconsistently and faces obstacles in the neonatal intensive care unit (NICU). The March of Dimes designed Close to Me to facilitate and increase KC in NICUs. The program incorporates KC education for nurses and parents, as well as awareness and comfort components. The purpose of this study was to assess whether Close to Me increased favorable attitudes toward KC among nurses and parents, and changed nurse and parent behaviors to implement KC earlier, more often and for longer duration.
Subjects And Design:
This study took place in 5 NICUs with 48 nurse participants and 101 parent participants. It used a pre-/postprogram implementation design for nurses and a nonequivalent comparison versus intervention group design for parents.
Methods:
Nurses and parents were surveyed on knowledge, attitudes, perceived behavioral control, and behavior. Comparisons were made pre- and postprogram implementation for nurses and between intervention and comparison groups for parents. Nurse focus groups were conducted pre- and postimplementation and analyzed using a constant comparative analysis method. Parents recorded care behaviors and satisfaction in journals, which were analyzed similarly.
Main Outcome Measures/Principal Results:
After the Close to Me intervention, nurses reported more positive attitudes toward KC (P = .04), increased transfer of ventilated babies from incubators to parents (P = .01), and more parents requesting KC. Parents who received Close to Me had greater knowledge about KC (P = .03) compared with those who did not. With the Close to Me intervention, all babies born at less than 28 weeks' gestation had KC by the age of 12 days, whereas without the intervention, some did not have KC until the age of 31 days (P < .05).
Conclusions:
March of Dimes Close to Me improved knowledge and behavior regarding KC in NICUs. By offering KC education to parents, providing KC awareness and comfort components, and providing information and encouragement on the benefits and feasibility of KC to nurses, hospitals can potentially promote earlier and more frequent use of KC, particularly with infants born less than 28 weeks' gestation.
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