title: A neonatal nurse training program in kangaroo mother care (KMC) decreases barriers to KMC utilization in the NICU.
abstract: OBJECTIVE
  This study assessed the impact of a nurse simulation training program on perception of kangaroo mother care (KMC) value and transfer skill competency.
  
  
  METHODS
  An 8-item Likert scale skill survey tool and a 24-item Likert developmental care survey tool were used in a prospective cohort study to analyze perceptions of 30 neonatal nurses who underwent a comprehensive KMC simulation-based training program. Competency skills were evaluated pretraining and tracked by direct observation for 6 months posttraining. Pre- and postsurvey data were analyzed and KMC utilization for preterm infants born at ≤ 34 weeks' gestation was determined.
  
  
  RESULTS
  Nurses' competency in infant transfer improved, especially in infants receiving nasal continuous positive airway pressure or ventilator support, from 30 to 93% or 10 to 50%, respectively, p < 0.0001. Neonatal nurses' perceived KMC value increased from 50 to 100%, p < 0.001, and parent KMC utilization increased from 26.5 to 85.9%, p < 0.0001. Nurses' support for parental visitation improved from 38 to 73%, p < 0.001; discussion of KMC with parents on the 1st day increased from 5 to 45%, p < 0.001; and initial day of KMC provision improved from 18.0 ± 2.7 to 5.6 ± 1.2 days, p < 0.001.
  
  
  CONCLUSIONS
  A comprehensive simulation-based KMC education program improved nurses' perception of KMC value, their competency and comfort in infant transfer for KMC care, and successfully promoted KMC parent utilization for the preterm infant in the neonatal intensive care unit.
authors.affiliation: Division of Neonatal Medicine, Virginia Commonwealth University School of Medicine, Children's Hospital of Richmond at VCU, Richmond, Virginia.
authors.forename: Karen D
authors.initials: KD
authors.lastname: Hendricks-Munoz
authors.affiliation: Neonatal Intensive Care Unit, Bellevue Hospital Center, New York, New York.
authors.forename: Roslyn M
authors.initials: RM
authors.lastname: Mayers
mesh_terms: D002983:Clinical Competence; D045422:Continuous Positive Airway Pressure; D004509:Education, Nursing, Continuing; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D060127:Kangaroo-Mother Care Method / Q000706:statistics & numerical data*; D008297:Male; D017283:Neonatal Nursing / Q000193:education*; D011446:Prospective Studies; D012121:Respiration, Artificial