NICU Nurses' Attitudes Toward Adopting an Evidence-Based Practice Intervention to Improve Bone Mineralization in Preterm Infants

BACKGROUND: Metabolic bone disease (MBD) is a disorder affecting bone mineralization that leads to short and long-term consequences. A daily exercise regimen consisting of passive range of motion (ROM) and gentle compression of upper and lower extremities shows promising results in improving bone mineralization in preterm infants. However, the lack of nursing literature suggests that nurses may underutilize these interventions. PURPOSE: This study examined Neonatal Intensive Care Unit (NICU) nurses' attitudes toward adopting passive ROM and gentle compression to improve bone mineralization in preterm infants and explored whether knowledge of MBD influences the implementation of these practices. METHODS: A quantitative, descriptive, cross-sectional survey of 238 NICU nurses was conducted. The Evidence-Based Practice Attitude Scale (EBPAS) assessed attitudes toward evidence-based interventions. Additional questions evaluated nurses' knowledge of MBD and their use of passive ROM and gentle compression in clinical practice. RESULTS: Results showed favorable attitudes toward evidence-based practice (EBPAS M = 2.92, SD = 0.565). In this sample, 23.1% of nurses reported routinely performing passive ROM, and 7.2% reported performing gentle compression of upper and lower extremities. The EBPAS demonstrated high reliability (α = 0.884) and strong convergent validity (r = 0.633). No significant differences were found by years of experience (P = .55) or certification (P = .39). Over half of respondents lacked knowledge about MBD etiology (53.4%) and prevention/treatment (59.7%). IMPLICATIONS FOR PRACTICE AND RESEARCH: Findings highlight a knowledge gap despite positive attitudes. Incorporating MBD education and exercise techniques into NICU training may help standardize these evidence-based interventions and improve outcomes for preterm infants.