Barriers to Provision of Developmental Care in the Neonatal Intensive Care Unit: Neonatal Nursing Perceptions

Abstract

The role of the neonatal nurse is vital for the successful implementation of developmental care and the provision of an optimal neonatal intensive care unit (NICU) environment. The goal was to identify nurses' perceived barriers to implementation or improving developmental care in their NICUs. Nursing perceptions related to barriers for implementing developmental care were assessed using a 12-point questionnaire during two New York City Neonatal Nursing regional conferences. One hundred forty-six (86%) of 170 nurses representing 24 regional hospitals returned the survey. Developmental care was viewed as essential by 136 nurses (93%), yet 125 nurses (86%) believed that their NICU was not providing optimal developmental care. Light and sound standards were viewed as important to providing care by 71% and 91% of respondents, respectively, yet only four NICUs (3%) had light and sound meters to identify or standardize this environmental source of pain. As a group, the perceived barriers to provision of optimal developmental care in order of decreasing importance were staff nurses and staff physicians (53%) > NICU funds (42%) > physician leadership (37%) > facility limitations (31%) > registered nurse leadership (25%). In contrast, 90% of nurses whose NICU did not use developmental multidisciplinary team meetings or developmental care champions or advocates were significantly more likely to identify nursing or physician colleagues as barriers to implementing or improving developmental care, compared with 38% of nurses whose NICU used such activities ( P < 0.001). Developmental care is perceived by the neonatal nurse as a vital component to the care provided in the NICU. Use of simple light and sound measures may enhance perception of providing an optimal NICU environment. Neonatal nurses perceived barriers to care are often attributed to neonatal staff nursing and physician colleagues. This perception is decreased considerably in those NICUs in which multidisciplinary team meetings or champions are used to address the needs of caregivers by providing developmental care strategies.

Factors that have an impact on knowledge, attitude and practice related to kangaroo care: National survey study among neonatal nurses

“…This finding was similar to previous study conducted by Franck, Bernal, and Gale (), who discussed that concerns about infant safety and co‐workers’ support could affect medical decisions. Even though nurses are capable of determining the use of KC with needed knowledge, the final implementation would greatly depend on physicians’ orders, since in China only physicians have the authority for care arrangements (Hendricks‐Munoz & Prendergast, ; Zhang et al., ). In a previous study, nurses identified nurse colleagues and staff physicians as major barriers to the implementation of developmental care (Hendricks‐Munoz et al., ).…”

“…Nursing staff are important advocates in the utilisation of neonatal care intervention. Nurses have a responsibility for the quality care and it is essential to provide adequate education and training to improve their knowledge and to develop their skills further(Flynn & Leahy-Warren, 2010;Hendricks- Munoz & Prendergast, 2007).6 | CONCLUSIONThis survey provides the general situation of KC in China. It is an uncommon practice despite its evidence-based benefits.…”

Nursing Care to Newborns with Respiratory Distress Syndrome in Intensive Care Unit

“…The nurse is the person who works together with the doctor in the decision conducting treatment, performing direct neonatal care and offering emotional support to families. [12] During the interviews, the nurses reported the importance of teamwork and how may be a facilitator for assistance. Teamwork is the set or group of people with complementary skills committed to each other for the mission and objectives obtained by negotiation between the actors involved and a work plan in common [13].…”

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“…Sin embargo, en Introduction psychological dimensions of the family (1) . Nurses assume an important role in the context of the NICU, because they develop collaborative work with the physician in the strategies and decisions, provide direct care to the newborn and give support to the family (2) . However, there are many difficulties that nurses face regarding…”