Breastfeeding and the Baby-Friendly Hospital Initiative: A Quality Improvement Project
Author DetailsAndrea K. (May) Velentine, DNP, PNP-C
Date of Publication2016-09-21
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The purpose of this DNP project was to provide support for nursing staff to feel empowered and motivated to provide new mothers with the support they needed to have a positive breastfeeding experience for their babies and themselves. Adult Learning Theory and the Rosswurm and Larrabee Model for Evidence-based Practice provided the framework for the project. A quasi-experimental study design was used to evaluate if the implementation of an educational intervention decreased barriers and improved nurses’ self-confidence in supporting mothers in the decision to breastfeed their infants. The project took place on the birthing center at a regional hospital in a Midwest state where approximately 120 infant deliveries occur monthly. The project director (PD) distributed an anonymous pre-intervention survey to all nursing staff in the birthing center by email using Qualtrics survey system to identify barriers that occurred when nurses tried to assist and educate a breastfeeding mother and to rate their self-confidence in assisting mothers. The PD recruited nursing staff for a breastfeeding taskforce through face-to-face communication and email separate from the survey. The breastfeeding taskforce, led by the PD, met to review survey data and brainstormed how to address identified breastfeeding education and support barriers. The taskforce developed two standardized staff education documents to address these barriers. Three months following the implementation of the newly written staff education, the PD distributed an anonymous post-intervention survey to all nursing staff by email that contained the same questions as in the pre- intervention survey. The PD analyzed the pre and post intervention survey data to determine if there was a decrease in barriers and increase of self-confidence in the nurses’ ability to assist patients with breastfeeding and support other nurses in the process. This information was shared with the taskforce to decide if any revisions in the written process were needed. No revisions were deemed necessary by the taskforce.
As a result of the findings of the breastfeeding taskforce and the PD, an algorithm titled. When Baby Does or Doesn’t Latch and a staff education sheet Nipple Shields 101 were created. When Baby Does or Doesn’t Latch was developed using Baby Friendly Hospital Initiative’s guidelines and the hospital’s hypoglycemia policy to provide nursing staff with a resource to use when babies are not breast or bottle feeding well. Nipple Shields 101 was created to give staff members a resource to use when assisting a patient that needs to use a nipple shield in order to help the baby to latch. Data gathered from the pre- and post- intervention surveys did show a statistically significant increase in the self-confidence the nursing staff felt when helping patients and each other with breastfeeding skills. Limitations on the study of outcomes for the project included time constraints, small survey sample, lack of ability to compare pre- and post-intervention survey results by person due to anonymity, and possible discrepancies in meaning of survey questions between PD and the survey participants.