Barriers to Developmental Care in the NICU: An Integrative Review

Area of Science:

• Neonatal care
• Developmental pediatrics
• Implementation science

Background:

• Variability in developmental care implementation within neonatal intensive care units (NICUs) is a recognized issue.
• Few studies have comprehensively explored the specific challenges hindering effective developmental care delivery.
• Addressing these barriers is crucial for optimizing outcomes for premature infants.

Purpose of the Study:

• To identify and analyze the barriers to implementing developmental care for premature infants.
• This integrative review synthesizes existing literature to understand challenges in NICU settings.
• Focuses on actionable insights for improving developmental care practices.

Main Methods:

• Systematic literature search conducted in CINAHL and PubMed databases.
• Timeframe for the search was 2014-2024.
• Included 2 qualitative and 5 quantitative studies for analysis.

Main Results:

• Thematic analysis identified three primary barriers to developmental care implementation.
• Barriers align with the theory of planned behavior: attitude, subjective norm, and perceived control.
• These factors significantly influence the adoption of developmental care strategies.

Conclusions:

• A multi-pronged strategy involving diverse stakeholders is recommended to enhance developmental care.
• Future research should utilize robust implementation science methodologies.
• Overcoming identified barriers requires a concerted and informed approach.