Barriers and facilitators to preparing families with premature infants for discharge home from the neonatal unit. Perceptions of health care providers


  • Marie Raffray RN, MSN (c). McGill University, Canada. email:
  • Sonia Semenic RN, Ph.D. Professor, McGill University, Canada. email:
  • Sandra Osorio Galeano RN, MSN. Professor, Professor Universidad de Antioquia UdeA, Calle 70 No. 52-21,Medellín, Colombia. email:
  • Sandra Catalina Ochoa Marín RN, Ph.D. Professor Universidad de Antioquia UdeA, Calle 70 No. 52-21,Medellín, Colombia. email:



Neonatal nursing, intensive care, neonatal, patient discharge, patient-centered care, Colombia.


Objective. To explore Colombian health care provider perceptions of barriers and facilitators to preparing families with premature infants for discharge home from the neonatal intensive care unit (NICU).

Methodology. Using a qualitative descriptive design, in-depth semi-structured interviews were conducted with fifteen neonatal health care providers (HCPs) in Colombia. Data were analyzed using qualitative content analysis.

Results. Participant responses centered on three main themes: 1) establishment of the parent-infant bond, 2) acquisition of parenting skills, and 3) getting ready for the transition from hospital to home. Barreirs to preparing parents for NICU discharge included obstacles to parental visiting in the NICU, communication barriers, difficulties related to the establishment of successful breastfeeding, insufficient human resources and poor links between hospital and community-based resources. Facilitators included the availability of social aids for vulnerable families, 24-hour telephone access to the neonatal units, tailored educational materials and group sessions, continuing education for staff and the community-based Kangaroo Program available to parents post-discharge. Adolescent mothers, indigenous parent and working fathers were identified as particularly challenging to reach and engage in discharge preparation.

Conclusion. Neonatal HCPs identified numerous challenges as well as helpful strategies for preparing families for hospital discharge.  Additional studies are needed on the experience of neonatal discharge from the perspective of parents of premature infants in Colombia, to help inform optimal interventions for supporting families during the transition from hospital to home.


How to cite this article: Raffray M, Osorio S, Ochoa SC, Semenic S. Barriers and facilitators to preparing families with premature infants for discharge home from the neonatal unit. Perceptions of  health care providers Invest Educ Enferm. 2014; 32(3): 

= 2479 veces | RESUMEN | RESUMO
= 37 veces| | PDF(ENGLISH)
= 722 veces| | HTML(ENGLISH)
= 129 veces|


Download data is not yet available.


(1) Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller A-B, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012; 379(9832):2162-72.

(2) Departamento Administrativo Nacional de Estadística. Estadísticas vitales nacimientos 2008. Bogotá, Colombia: Departamento Administrativo Nacional de Estadística; 2008.

(3) Escobar DSG, Celis NEB, Reatiga MFS. Determinantes estresores presentes en madres de neonatos pretérmino hospitalizados en las Unidades de Cuidados Intensivos. Rev Cienc y Cuid. 2012; 9(1):43-53.

(4) Obeidat HM, Bond EA, Callister LC. The parental experience of having an infant in the newborn intensive care unit. J Perinat Educ. 2009; 18(3):23-9.

(5) Smith VC, Hwang S, Dukhovny D, Young S, Pursley DM. Neonatal intensive care unit discharge preparation, family readiness and infant outcomes: connecting the dots. J Perinat. 2013; 33(6):415-21.

(6) Burnham N, Feeley N, Sherrard K. Parents' perceptions regarding readiness for their infant's discharge from the NICU. Neonatal Netw. 2013; 32(5):324-34.

(7) Rabelo MZdS, Chaves EMC, Cardoso MVLML, Sherlock MdSM. Feelings and expectations of mothers of preterm babies at discharge. Acta Paul Enferm. 2007; 20(3):333-7.

(8) Sisk P, Quandt S, Parson N, Tucker J. Breast milk expression and maintenance in mothers of very low birth weight infants: supports and barriers. J Hum Lact. 2010; 26(4):368-75.

(9) Reyna BA, Pickler RH, Thompson A. A descriptive study of mothers’ experiences feeding their preterm infants after discharge. Adv Neonatal Care. 2006; 6(6):333.

(10) Sneath N. Discharge teaching in the NICU: are parents prepared? An integrative review of parents' perceptions. Neonatal Netw. 2009; 28(4):237-46.

(11) Frello AT, Carraro TE. Enfermagem ea relação com as mães de neonatos em unidade de terapia intensiva neonatal. Rev Bras Enferm. 2012; 65(3):514-21.

(12) Griffin T, Abraham M. Transition to home from the newborn intensive care unit: applying the principles of family-centered care to the discharge process. J Perinat Neonatal Nurs. 2006; 20(3):243-9.

(13) Amaral Martins L, Santos da Silva D, De Souza Azevedo Aguiar AC, Cedraz Morais A. Insertion of the family in the neonatal intensive care unit: a systematic review. J Nurs UFPE. 2012; 6(4):861-8.

(14) Merritt TA, Pillers D, Prows SL. Early NICU discharge of very low birth weight infants: a critical review and analysis. Semin Neonatol. 2003; 8(2):95-115.

(15) Mills MM, Sims DC, Jacob J. Implementation and case-study results of potentially better practices to improve the discharge process in the neonatal intensive care unit. Pediatr. 2006; 118(Supplement 2):S124-S33.

(16) Schmidt KT, Bessa JB, Rodrigues BC, Arenas MM, Corrêa DAM, Higarashi IH. Recém-nascidos prematuros ea alta hospitalar: uma revisão integrativa sobre a atuação da enfermagem; Premature newborns and hospital discharge: an integrative review on nursing performance. Rev RENE. 2011; 12(4):849-58.

(17) Rochefort CM, Clarke SP. Nurses’ work environments, care rationing, job outcomes, and quality of care on neonatal units. J Adv Nurs. 2010; 66(10):2213-24.

(18) Malvárez S, Castrillón C. Overview of the nursing workforce in Latin America (Series Human Resources Development No. 39). Washington, DC: Human Resource Development Unit, Strategic Heath Development Area. Pan American Health Organization; 2005.

(19) Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008; 62(1):107-15.

(20) Lincoln YS, Guba HS. Naturalistic Inquiry. Sage Publications, Incorporated, London, UK; 1985.

(21) Heermann JA, Wilson ME, Wilhelm PA. Mothers in the NICU: outsider to partner. Pediatr Nurs. 2005; 31(3):176-81.

(22) Hopwood R. The role of the neonatal nurse in promoting parental attachment in the NICU. Infant. 2010; 6(2):54-8.

(23) Johnson AN. Engaging fathers in the NICU: taking down the barriers to the baby. J Perinat Neonatal Nurs. 2008; 22(4):302-6.

(24) Walsh J, Goser L. Development of an Innovative NICU Teen Parent Support Program. J Perinat Neonatal Nurs. 2013; 27(2):176-83.

(25) Martins DC, Mello D, Scochi CGS. Crianças prematuras e de baixo peso ao nascer em famílias de baixo nível socioeconômico: uma revisão da literatura. Pediatr Mod. 2001; 37(9):2001.

(26) Renfrew M, Craig D, Dyson L, McCormick F, Rice S, King S, et al. Breastfeeding promotion for infants in neonatal units: a systematic review and economic analysis. Health Technol Assess. 2009; 13(40):1-146.

(27) Schlittenhart JK, Smart D, Miller K, Severtson, B. Preparing parents for NICU discharge. Nurs Wom Health. 2011; 15(6): 484-494.



How to Cite

Raffray, M., Semenic, S., Osorio Galeano, S., & Ochoa Marín, S. C. (2014). Barriers and facilitators to preparing families with premature infants for discharge home from the neonatal unit. Perceptions of health care providers. Investigación Y Educación En Enfermería, 32(3).




Most read articles by the same author(s)

Similar Articles

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 > >> 

You may also start an advanced similarity search for this article.