NICU Nurses' Knowledge and Practices on Maternal Voice Exposure for Preterm Infants

ABSTRACT Background: Maternal voice exposure provides significant neurodevelopmental benefits for preterm infants, yet its integration into routine clinical care remains inconsistent. Understanding the “knowledge-to-action” gap is critical for establishing effective developmental care practices in the neonatal intensive care unit (NICU). Purpose: To determine the knowledge levels of NICU nurses regarding maternal voice exposure, evaluate their clinical practices, and identify perceived systemic barriers to implementation. Methods: A descriptive, cross-sectional design was used. Data were collected from 166 NICU nurses across Türkiye using a structured knowledge questionnaire (content validity index = 0.99) and a clinical practice assessment tool. Statistical analyses included descriptive statistics and group comparisons ( t -tests and analysis of variance). Results: The mean knowledge score was high (82.70 ± 9.29). Despite this, 75.9% of nurses did not implement maternal voice exposure in their units. A significant majority (94.0%) reported a total absence of written protocols. Key barriers identified were lack of guidelines, time constraints, and equipment shortages. Knowledge scores positively correlated with age and professional experience ( P < .05). Implications for Practice and Research: Although NICU nurses possess high theoretical knowledge, a profound “knowledge-to-action” gap exists. The primary systemic barrier is the lack of standardized, evidence-based written protocols. Neonatal intensive care unit leadership should prioritize developing clinical guidelines and nursing education programs that address perceived barriers, such as infection control and equipment use, to transition theoretical knowledge into routine bedside practice.