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Factors Influencing Implementation of Kangaroo Holding in a Special Care Nursery

Johnson, Amy Nagorski DNSc, RNC

MCN, American Journal of Maternal Child Nursing:
feature article

Purpose: To describe factors identified by nurses that promote kangaroo holding in the Special Care Nursery (SCN) environment.

Study Design and Methods: Descriptive survey. Sixty-seven experienced registered nurses completed a survey to identify factors that support the implementation of kangaroo holding, including assessment strategies of the infant and family, staffing requirements, and necessary environmental considerations at a 70-bed tertiary care, Level III SCN.

Results: Although the primary factor for implementing kangaroo holding was the assessed physiologic stability of the infant (stated by 98.5% of nurses), other factors identified as integral components included adequate staffing patterns, maternal readiness, and encouragement from management. Nurses with 5 or more years of SCN practice were more likely to implement kangaroo care (KC) as an intervention to support attachment for any gestational age neonate.

Clinical Implications: The nurses in this study identified management support as an essential factor in utilizing KC, including “educational programs,” “adequate staffing” (so coworkers could help if necessary), and “encouragement” from management as factors that support the practicing nurse in instituting KC. Nursing managers can use this information to help start KC programs in their settings that include adequate education for staff, appropriate staffing to allow time for parent education, and a supportive approach toward fostering KC among infants and parents.

In Brief

Don't we all know that kangaroo care is a good thing for newborns? Why is it that some nurses find it difficult to implement?

Author Information

Amy Nagorski Johnson is an Associate Professor of Nursing, School of Nursing, University of Delaware, Newark. She can be reached via e-mail at

This study was funded by the University of Delaware's General University Research Fund.

© 2007 Lippincott Williams & Wilkins, Inc.