Date of Conferral

2018

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barbara Gross

Abstract

Kangaroo care (KC) is a cost-efficient method to increase infant-parent bonding and neonatal health outcomes worldwide. Despite evidence supporting KC in critically ill infants, nursing perceptions regarding patient safety and interrupted work flow continued to impede practice in the local high-tech neonatal intensive care unit (NICU). Their current policy failed to address the 2-person transfer method recommended for safe practice. In addition, both staff and parents lacked training and education regarding the benefits and feasibility of KC. This doctoral project aimed to decrease practice barriers and promote earlier and more frequent KC by developing and integrating an evidence-based clinical pathway within a multifaceted champion-based simulated educational training program for NICU staff and parents. Published outcomes and generated organizational data for program synthesis connected the gap in practice. Kolcaba's comfort theory served as the guiding framework to ensure a partnership in care. This quasi-experimental quantitative study used the generalized liner model for data analysis. Study findings indicated that KC occurred 2.4 more times after the intervention compared to before (p = 0.001). Descriptive data revealed that KC episodes for intubated patients nearly doubled after implementation (11.1% from 6.2%). Post-survey scores for nursing knowledge and comfort level also improved after the intervention. Although earlier KC practice was non-conclusive (p = 0.082), future trials should control groups for day of life since admission. Disseminating the KC pathway can have a positive social change on family-centered care by increasing NICU nurses' knowledge, comfort, and adoption of this evidence-based practice as an expected routine standard of care.

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