Nurses’ perspectives on neuroprotective care in the NICU: A Focus Group study of practices, barriers, and facilitators

Purpose To explore neonatal nurses’ perspectives on neuroprotective care in Neonatal Intensive Care Units and identify interventions, facilitators, and barriers to its implementation. Design and methods A qualitative descriptive study used six online focus groups with 27 experienced and specialist neonatal nurses from Neonatal Intensive Care Units across mainland Portugal, recruited through snowball sampling. Data were analyzed inductively and mapped onto the Neonatal Integrative Developmental Care Model, following COREQ. Results Neuroprotective care was perceived as a core, family-centered component of neonatal practice. The most frequently reported intervention domains were Family Partnership and Safe Environment. Facilitators included training, multidisciplinary collaboration, and organizational support, while barriers, particularly workload, limited resources, and insufficient institutional investment, were reported more frequently and hindered consistent implementation. Conclusion Neonatal nurses demonstrate strong conceptual alignment with neuroprotective care principles, but its implementation remains inconsistent and organizationally constrained. Strengthening institutional support, training, and care standardization is crucial to routine practice.