Publication:

Early kangaroo mother care in preterms weighing ≤1250 grams: before and after training program in neonatal nurses

Background Kangaroo mother care (KMC) is an evidence based approach to reduce mortality and morbidity in preterm neonates. Knowing nurses’ perception to early initiation of KMC will help scale-up this intervention. This study aimed to know barriers to early initiation of KMC in neonates weighing ≤1250 grams among nurses and effect of structured training programme on their perception and KMC provision.

Methods A prospective COHORT study was conducted at level three NICU where 40 nurses were interviewed by a predesigned questionnaire followed by KMC training and practice phase. Repeat survey was conducted at the end of the study to know change in nursing perception.

Results Two themes identified from the pre KMC training questionnaire were: Infant related barriers and nursing practice related barriers. Among infant related barriers KMC training significantly reduced nurses’ hesitation for KMC initiation in neonates with gestation age <28 weeks (45% to 20%), invasive ventilation (55% to 25%), UVC in situ (70% to 50%) and PICC in situ (52.5% to 22.5%). Nurses also felt more confident to continue KMC for longer hours (p value 0.002). Post KMC training initial day of KMC provision improved from 4.8 (±0.89) to 3.8 (±0.83).

Conclusions Identification of barriers to early KMC initiation and addressing them by standardized comprehensive training programme improves nurses’ perception and