Nurses' adherence to the Kangaroo Care Method: support for nursing care management

Nurses' Kangaroo Mother Care practice implementation and future challenges: an integrative review

BACKGROUND

Nurses play a crucial role in Kangaroo Mother Care practice, but their application in specific policies and practices involves challenges. A comprehensive literature review is needed to improve understanding of specific barriers that are most relevant to nurses and the improvement of this practice. This review investigates nurses' barriers in implementing Kangaroo Mother Care, in order to illustrate directions for future research.

METHODS

This study was based on integrative review method and exploring nurses' barriers in implementing Kangaroo Mother Care, strategies to reduce its barriers. CINAHL, Medline, Web of Science, ProQuest Nursing and Allied Health Database, PubMed and Science Direct Taylor & Francis databases were searched for the following: (i) studies with no year restrictions, (ii) peer-reviewed journal articles, (iii) original research and (iv) articles written in English. Each article was appraised for methodological validity review using critical appraisal checklist.

RESULTS

The search revealed 19 articles from diverse countries. Four main themes were generated from the synthesis of the findings: (i) barriers related to nurses' perspective and emotion towards KMC, (ii) healthcare institution barriers towards KMC, (iii) barriers related to parental experience in providing KMC and (iv) strategy to improve KMC implementation.

CONCLUSIONS

Nurses experience several barriers in successfully implementing KMC in healthcare settings. This review reported strategies to reduce KMC barriers and to improve its utilisation in healthcare settings. Hospitals should establish adequate manpower, clear guidelines, sufficient supplies and equipment, capacity building among staff and proper Kangaroo Mother Care information dissemination for patients.

Management challenges for best practices of the Kangaroo Method in the Neonatal ICU

OBJECTIVE

To understand the conditions that influence the adherence and application of best practices by nurses in the context of the Nursing care management in the Kangaroo Mother Care in the Neonatal ICU.

METHOD

Study of qualitative approach, whose theoretical and methodological frameworks were Symbolic Interactionism and Grounded Theory, respectively. We used the in-depth interview with 8 nurses from the Neonatal ICU of a public maternity hospital in the city of Rio de Janeiro.

RESULTS

The conditions involved in adhering to the best practices of humanization in the Neonatal ICU are related mainly to human resources, interaction among professionals, work processes and leadership strategies; and care management.

CONCLUSION

Professional and institutional challenges have been identified that need to be addressed to improve adherence and implementation of the Kangaroo Mother Care best practices.

Kangaroo mother care: a systematic review of barriers and enablers

OBJECTIVE

To investigate factors influencing the adoption of kangaroo mother care in different contexts.

METHODS

We searched PubMed, Embase, Scopus, Web of Science and the World Health Organization's regional databases, for studies on "kangaroo mother care" or "kangaroo care" or "skin-to-skin care" from 1 January 1960 to 19 August 2015, without language restrictions. We included programmatic reports and hand-searched references of published reviews and articles. Two independent reviewers screened articles and extracted data on carers, health system characteristics and contextual factors. We developed a conceptual model to analyse the integration of kangaroo mother care in health systems.

FINDINGS

We screened 2875 studies and included 112 studies that contained qualitative data on implementation. Kangaroo mother care was applied in different ways in different contexts. The studies show that there are several barriers to implementing kangaroo mother care, including the need for time, social support, medical care and family acceptance. Barriers within health systems included organization, financing and service delivery. In the broad context, cultural norms influenced perceptions and the success of adoption.

CONCLUSION

Kangaroo mother care is a complex intervention that is behaviour driven and includes multiple elements. Success of implementation requires high user engagement and stakeholder involvement. Future research includes designing and testing models of specific interventions to improve uptake.