NICU Nurses' Perceptions of Early Skin-to-Skin Contact With Extremely Preterm Infants

Background: Early skin-to-skin contact (SSC) is an evidence-based care practice with well-documented benefits for preterm infants and their parents. Among extremely preterm infants, implementation of early SSC remains variable across neonatal intensive care units (NICUs), despite growing evidence supporting its safety. Nurses play a central role in facilitating SSC, and their perceptions and perceived barriers may influence its implementation. Purpose: To describe NICU nurses' perceptions of early SSC for extremely preterm infants and to identify perceived barriers to its implementation in neonatal intensive care settings. Methods: A descriptive cross-sectional study using a web-based survey was conducted among NICU nurses in Finnish university hospitals. A total of 148 nurses responded, and the data were analyzed using descriptive statistics and one-way analysis of variance. Results: Most nurses held positive perceptions toward early SSC, whereas most considered it not feasible for all extremely preterm infants, and many reported safety-related and family-related concerns. Perceived barriers varied significantly between NICUs ( P < .001) and by NICU experience ( P = .018), with higher barriers among nurses with 2-5 years of experience. Early SSC was not perceived by most nurses to increase workload. Implications for Practice and Research: Consistent implementation of early SSC appears to depend on unit-level practices and nurses' experience. Clear clinical guidance, staff education, and parental support may facilitate its integration into routine neonatal care, whereas further research is needed to identify effective implementation strategies.