Determinants of Nurses’ Professional Compliance with Standards of Care for Low Birth Weight Infants: A Multicenter Study

Authors

  • Erni Juniartati Jurusan Keperawatan Singkawang, Poltekkes Kemenkes Pontianak, Indonesia
  • Marsia Jurusan Keperawatan Singkawang, Poltekkes Kemenkes Pontianak, Indonesia
  • Finta Isti Kundari Poltekkes kemenkes Semarang Prodi Kebidanan Purwokerto, Indonesia
  • Diki Retno Yulianti Poltekkes Kemenkes Malang Prodi Kebidanan Kediri, Indonesia
  • Suhariyanto Poltekkes Kemenkes Malang Prodi Kebidanan Kediri, Indonesia

DOI:

https://doi.org/10.55681/armada.v4i9.4273

Keywords:

LBW Infants, Nurse Compliance, Clinical Career Level, Care Standards, Multicenter Study

Abstract

Low birth weight infants (LBWIs) have a high risk of complications and therefore require consistent and standardised care. Nurses’ adherence to LBWI care standards plays an important role in maintaining service quality and patient safety. This study aimed to identify factors associated with nurses’ adherence to LBWI care standards and determine the dominant factor in a multicentre setting. This quantitative analytical observational study used a cross-sectional design involving nurses providing care for LBWIs. Data were collected using a respondent characteristics questionnaire and an adherence checklist, then analysed using bivariate analysis and multiple linear regression. The results showed that the mean age of respondents was 38.53 ± 8.57 years, length of employment was 14.87 ± 8.86 years, and adherence score was 25.43 ± 2.05. Age, length of employment, and clinical career level (PK/BP) were significantly associated with adherence (p=0.001), while education and LBWI training were not significant. Clinical career level was the dominant factor influencing adherence (B=1.472; p=0.005), with the model explaining 65.5% of adherence score variation (Adjusted R²=0.655). Strengthening clinical career pathways, competency assessment, supervision, and continuous evaluation are required to improve consistent implementation of LBWI care standards.

Downloads

Download data is not yet available.

References

Almarwani, A. M., & Alzahrani, N. S. (2023). Factors affecting the development of clinical nurses’ competency: A systematic review. Nurse Education in Practice, 73, 103826. https://doi.org/https://doi.org/10.1016/j.nepr.2023.103826

Cassidy, C. E., Harrison, M. B., Godfrey, C., Nincic, V., Khan, P. A., Oakley, P., Ross-White, A., Grantmyre, H., & Graham, I. D. (2021). Use and effects of implementation strategies for practice guidelines in nursing: a systematic review. Implementation Science : IS, 16(1), 102. https://doi.org/10.1186/s13012-021-01165-5

Deligianni, M., Voultsos, P., Tzitiridou-Chatzopoulou, M. K., Drosou-Agakidou, V., & Tarlatzis, V. (2023). Moral distress among neonatologists working in neonatal intensive care units in Greece: a qualitative study. BMC Pediatrics, 23(1), 114. https://doi.org/10.1186/s12887-023-03918-1

Derdiarian, A. K. (1993a). Application of the Johnson Behavioral System Model in nursing practice. NLN Publications, 15–2548, 285–298.

Derdiarian, A. K. (1993b). The Johnson Behavioral System Model: perspectives for nursing practice. NLN Publications, 15–2548, 267–284.

Forsetlund, L., O’Brien, M. A., Forsén, L., Reinar, L. M., Okwen, M. P., Horsley, T., & Rose, C. J. (2021). Continuing education meetings and workshops: effects on professional practice and healthcare outcomes. The Cochrane Database of Systematic Reviews, 9(9), CD003030. https://doi.org/10.1002/14651858.CD003030.pub3

Fukada, M. (2018). Nursing Competency: Definition, Structure and Development. Yonago Acta Medica, 61(1), 1–7. https://doi.org/10.33160/yam.2018.03.001

Gallione, C., Barisone, M., Molon, A., Pavani, M., Torgano, C., Bassi, E., & Dal Molin, A. (2022). Extrinsic and intrinsic factors acting as barriers or facilitators in nurses’ implementation of clinical practice guidelines: a mixed-method systematic review. Acta Bio-Medica : Atenei Parmensis, 93(3), e2022252. https://doi.org/10.23750/abm.v93i3.12942

Groupa, C. of P. or L. B. I. (2023). New World Health Organization recommendations for care of preterm or low birth weight infants: health policy. EClinicalMedicine, 63, 102155. https://doi.org/10.1016/j.eclinm.2023.102155

Hui, T., Zakeri, M. A., Soltanmoradi, Y., Rahimi, N., Hossini Rafsanjanipoor, S. M., Nouroozi, M., & Dehghan, M. (2023). Nurses’ clinical competency and its correlates: before and during the COVID-19 outbreak. BMC Nursing, 22(1), 156. https://doi.org/10.1186/s12912-023-01330-9

Jebessa, S., Litch, J. A., Senturia, K., Hailu, T., Kahsay, A., Kuti, K. A., Wolka, E., Teklu, A. M., & Gezahegn, W. (2021). Qualitative Assessment of the Quality of Care for Preterm, Low Birth Weight, and Sick Newborns in Ethiopia. Health Services Insights, 14, 11786329211025150. https://doi.org/10.1177/11786329211025150

Rahmah, N. M., Hariyati, T. S., & Sahar, J. (2021). Nurses’ efforts to maintain competence: a qualitative study. Journal of Public Health Research, 11(2). https://doi.org/10.4081/jphr.2021.2736

Rahmawati, I., M., A., Juliningrum, P., & Sulistyorini, L. (2025). The overview of nurses’ performance in low-birth-weight care in agricultural areas. Nursing and Health Sciences Journal (NHSJ), 5, 92–101. https://doi.org/10.53713/nhsj.v5i1.474

Saiga, M., Yamamoto, Y., Okuda, R., & Fukada, M. (2024). Relationship Between Clinical Nursing Competence and Work Environment by Career Stage for Nurses with 1-10 Years of Clinical Experience. Yonago Acta Medica, 67(1), 9–21. https://doi.org/10.33160/yam.2024.02.002

Silitonga, E. M. I., Hariyati, R. T. S., Handiyani, H., & Wildani, A. A. (2026). Fostering critical thinking competence in nurses: A systematic review. Nurse Education in Practice, 92, 104730. https://doi.org/https://doi.org/10.1016/j.nepr.2026.104730

Weng, Y.-H., Chen, C., Kuo, K. N., Yang, C.-Y., Lo, H.-L., Chen, K.-H., & Chiu, Y.-W. (2015). Implementation of evidence-based practice in relation to a clinical nursing ladder system: a national survey in Taiwan. Worldviews on Evidence-Based Nursing, 12(1), 22–30. https://doi.org/10.1111/wvn.12076

WHO. (2022). WHO recommendations for care of the preterm or low-birth-weight infant. https://www.who.int/publications/i/item/9789240058262

WHO. (2026). Low birth weight. https://www.who.int/data/nutrition/nlis/info/low-birth-weight?

Zaitoun, R. A., Said, N. B., & de Tantillo, L. (2023). Clinical nurse competence and its effect on patient safety culture: a systematic review. BMC Nursing, 22(1), 173. https://doi.org/10.1186/s12912-023-01305-w

Downloads

Published

2026-09-30

How to Cite

Juniartati, E., Marsia, Finta Isti Kundari, Diki Retno Yulianti, & Suhariyanto. (2026). Determinants of Nurses’ Professional Compliance with Standards of Care for Low Birth Weight Infants: A Multicenter Study. ARMADA : Jurnal Penelitian Multidisiplin, 4(9), 5762–5773. https://doi.org/10.55681/armada.v4i9.4273