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

Abstract

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.

Postpartum Experiences of Early Skin-to-Skin Contact and the Traditional Separation Approach After a Very Preterm Birth: A Qualitative Study Among Mothers

“…One mother in our study did not see or touch her newborn for 30 hours after the birth. Our findings are in accordance with other studies in which unexpected events or critical health conditions related to the mother or the infant resulted in a long separation time ( Maniago et al, 2020 ; Vaerland et al, 2018 ). Maastrup et al (2018) showed the value of experiencing SSC in a case where extremely preterm twins did not survive, indicating “it is important to avoid delaying the initiation of SSC” (p. 551).…”

“…One mother in the TC group considered that TC might be a safer intervention than early SSC due to the risk of unexpected infant instability during the early SSC session. Safety concerns have been shown in other studies as obstacles to early SSC ( Hubbard & Gattman, 2017 ; Maniago et al, 2020 ). However, all mothers who received early SSC in our study described a feeling of safety by mentioning crucial aspects such as adequate information, monitoring, and the constant presence of health professionals who followed a detailed early SSC procedure and were close by the whole time.…”

“…However, all mothers who received early SSC in our study described a feeling of safety by mentioning crucial aspects such as adequate information, monitoring, and the constant presence of health professionals who followed a detailed early SSC procedure and were close by the whole time. A recent review by Maniago et al (2020) underlines many of the same aspects to improve utilization of SSC (named as Kangaroo Mother Care): “adequate manpower, clear guidelines, sufficient supplies and equipment, capacity buildings among staff and proper kangaroo mother care information dissemination for patients” (p. 293). One question in our interview guide referred to whether the mothers in the early SSC group worried about having their very preterm infant in a skin-to-skin position when the infant was connected to several medical-technical equipment.…”

“…However, Dahlø et al (2018) indicated how mothers’ feeling of safety is supported by calm nurses taking care of medical equipment and assessing the infant’s condition. Maniago et al (2020) highlighted how nurses may receive education and support on how to safely assist parents in this situation. This is essential when facilitating early SSC and indicates an important implication for future practice.…”

“…Low gestational age is perceived as one of the barriers to initiating early SSC ( Niela-Vilén et al, 2013 ). Other barriers include safety concerns, a lack of staff and guidelines, established routines, a lack of knowledge, and health professionals’ reluctance to change ( Hubbard & Gattman, 2017 ; Maniago et al, 2020 ; WHO, 2003 ). However, in recent years, several studies have confirmed the safety, feasibility, and benefits of early SSC for moderately preterm infants from 32 weeks of gestation ( Kristoffersen, Stoen et al, 2016 ).…”