Institutional members access full text with Ovid®

Share this article on:

Kangaroo Care: National Survey of Practice,Knowledge, Barriers, and Perceptions

Engler, Arthur J. DNSc, RNC, APRN; Ludington-Hoe, Susan M. PhD, CNM, FAAN; Cusson, Regina M. PhD, RNC, APRN; Adams, Rene MS, RNC; Bahnsen, Millie MS, RNC, CRNP; Brumbaugh, Eileen MS, RNC, NNP; Coates, Patricia MS, RNC, CRNP; Grieb, Jane MS, RNC, NNP; McHargue, Lisa MS, RNC, CRNP; Ryan, Deborah L. MS, RNC, NNP; Settle, Mary MS, RNC, NNP; Williams, Denise MS, RNC, CRNP

MCN: The American Journal of Maternal/Child Nursing: May-June 2002 - Volume 27 - Issue 3 - p 146-153
feature articles

Purpose A national survey was conducted to assess practice, knowledge, barriers, and perceptions regarding Kangaroo Care (KC)—the holding of diaper-clad preterm infants skin-to-skin, chest-to-chest by parents.

Design A descriptive survey was conducted.

Methods Kangaroo Care Questionnaires (KCQs), developed for the study, were sent to nurse managers in all hospitals in the United States that were identified as providing neonatal intensive care services (N = 1,133), and were to be completed by the nurse most familiar with the practice of KC in that unit. A second KCQ was sent to nonrespondents. Descriptive statistics were used to summarize the data.

Results A response rate of 59% (N = 537) was achieved. Over 82% of the respondents reported practicing KC in their neonatal intensive care units (NICUs). Nurses were knowledgeable about KC. Major barriers to practicing KC for certain types of infants were infant safety concerns, as well as reluctance by nurses, physicians, and families to initiate or participate in KC. Many NICUs do not permit KC for certain types of infants (e.g., those on vasopressors or high-frequency ventilation). Over 60% of respondents agreed that low gestational age or weight were not contraindications. Respondents from NICUs in which KC is practiced were more positive in their perceptions than respondents from NICUs that do not practice KC.

Clinical Implications The findings suggest that in order to overcome barriers to the practice of KC, nurses need educational offerings highlighting the knowledge and skills needed to provide KC safely and effectively. These educational offerings should also emphasize the value of KC to infants and parents. In addition, knowledgeable practitioners need to develop evidence-based policies and procedures that will lead to successful KC.

Arthur J. Engler is a an Assistant Professor, University of Connecticut, Storrs, CT. He can be reached c/o University of Connecticut, School of Nursing, 231 Glenbrook Road, Unit-2026, Storrs, CT 06269 (e-mail:

Susan M. Ludington-Hoe is the Carl W. and Margaret Davis Walter Professor of Pediatric Nursing, Case Western University, Cleveland, OH.

Regina M. Cusson is a Professor, University of Connecticut, Storrs, CT.

Rene Adams is a Clinical Manager, Greater Baltimore (MD) Medical Center, Baltimore, MD.

Millie Bahnsen is a Neonatal Nurse Practitioner, Mercy Medical Center, Baltimore, MD.

Eileen Brumbaugh is a Neonatal Nurse Practitioner, Winchester Medical Center, Winchester, VA.

Patricia Coates is a Neonatal Nurse Practitioner, Sinai Hospital of Baltimore, MD.

Jane Grieb is a Nurse Manager, Keesler Air Force Base, Biloxi, MS.

Lisa McHargue is a Neonatal Nurse Practitioner, Union Hospital of Cecil County, MD.

Deborah L. Ryan is a Neonatal Nurse Practitioner, Children’s National Medical Center, Washington, DC.

Mary Settle is a Neonatal Nurse Practitioner, Scott & White Memorial Hospital, Temple, TX.

Denise Williams is a Neonatal Nurse Practitioner, Lee Regional Hospital, Johnstown, PA.

Copyright © 2002 Wolters Kluwer Health, Inc. All rights reserved