The attitudes and practices of neonatal nurses in the use of kangaroo care.

OBJECTIVES To survey the attitudes and practices of Australian neonatal nurses in the use of kangaroo care (KC) and identify possible concerns with promoting KC in the neonatal intensive care unit (NICU). DESIGN A two-phase research approach was used that included a descriptive survey followed by in-depth interviews with a subset of survey respondents. SAMPLE Thirty four nurses working in the NICU of a large public hospital in Melbourne completed a survey questionnaire. Four respondents were subsequently selected for follow-up interview to explore in greater depth issues associated with promoting KC in the NICU. OUTCOME MEASURES Quantitative data were analysed to describe the attitudes, practices and role of the neonatal nurse in promoting KC. Analysis of qualitative responses to survey questions and interviews were coded and major themes identified. RESULTS All neonatal nurses surveyed assisted and encouraged parents to provide KC and the majority agreed on the benefits of KC for both infant and parents. There was a general acceptance that KC can be practiced with low birth weight infants requiring intubation and all but two nurses found facilitating KC professionally satisfying. Results also identified practical concerns with the practice of KC and some uncertainty that KC promotes breastfeeding. Notable constraints to promoting KC in the NICU were heavy staff workloads, insufficient education, lack of organisational support and the absence of clear protocols, especially for low birth weight infants. CONCLUSIONS This study confirms neonatal nurses strongly support the use of KC in the NICU. Although the majority of nurses reported positive attitudes and practices, they did identify a number of educational and practical concerns that need to be addressed to ensure KC with low birth weight infants is safe and effective.