An evaluation of educational interventions used within neonatal intensive care units globally to enhance communication between nurses and parents: a systematic review with narrative synthesis

Aim To assess evidence on the effectiveness of educational interventions to improve neonatal intensive care unit (NICU) nurses’ communication with parents. Background Effective communication between nurses and parents in NICUs is essential but often challenging to achieve due to the high-stress environment, the complexity of the information nurses convey and parents’ emotional distress. Thus, there is a need for effective educational interventions to improve NICU nurses’ communication skills. Design Systematic review with narrative synthesis. Methods Studies published from inception to May 2025 were searched across CINAHL, Embase, MEDLINE, PsycInfo, Scopus and Web of Science. Eligible studies reported on educational interventions for nurse–parent communication in NICUs. Study quality was assessed using the Mixed Methods Appraisal Tool and data were narratively synthesised. Results The search yielded 2810 records, of which 13 studies were included in the narrative synthesis. The analysis identified three key themes. First, the design of an intervention influenced its effectiveness, particularly through the use of explicit theoretical frameworks and the extent of stakeholder engagement. Second, interventions employing experiential learning approaches were generally effective, but their impact in practice was constrained by feasibility challenges and systemic barriers, such as a high clinical workload. Third, the quality of the evidence base was impaired by methodological weaknesses, including an over-reliance on self‑reported outcomes, small sample sizes and short‑term follow‑up. Conclusion Real-world success of educational interventions to enhance NICU nurses’ communication skills requires designs that are theoretically sound, contextually feasible and methodologically robust.