Our Journey toward Exclusive Breast Milk Feeding: A System-Wide Approach for Lactation Services
Article first published online: 14 JUN 2012
© 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Special Issue: 2012 Convention Proceedings
Volume 41, Issue s1, pages S84–S85, June 2012
How to Cite
Hite, C. M., Perry, L. A., Rice, M. K., Dolinger, L. K. and Bradburn, C. R. (2012), Our Journey toward Exclusive Breast Milk Feeding: A System-Wide Approach for Lactation Services. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 41: S84–S85. doi: 10.1111/j.1552-6909.2012.01361_43.x
- Issue published online: 14 JUN 2012
- Article first published online: 14 JUN 2012
- exclusive breastfeeding;
- breast milk;
- bedside nurse
Purpose for the Program
When the Joint Commission identified “exclusive breast milk for all term infants” as a 2010 core measure, we were challenged to increase exclusive breast milk feeding rates in a multihospital system using the limited resources of four international board certified lactation consultants. A vast amount of evidence demonstrates that exclusive breastfeeding in the hospital setting leads to increased breastfeeding success rates in the later postpartum period. Research indicates that the knowledge and training of the bedside nurse is essential in supporting the breastfeeding dyad.
The four international board certified lactation consultants collaborated to develop educational tools and training to assist the bedside nurses with providing evidenced-based breastfeeding assistance.
Implementation, Outcomes, and Evaluation
A baseline competency assessment was completed using an online training module for all bedside nurses in this large health care system. Twenty-five frontline nurses were then given the opportunity to attend an on-site certified lactation counselor course. Each certified lactation counselor was assigned a mentor international board certified lactation consultant for guidance and support. Once the certified lactation counselor demonstrated competency with the international board certified lactation consultant, the certified lactation counselor continued providing staff education and completed competency evaluations for each bedside nurse. Criteria were developed outlining the roles of the bedside nurse, the certified lactation counselor, and the international board certified lactation consultant. A triage tool also was developed to identify the breastfeeding dyads at risk and requiring further international board certified lactation consultant consultation. An extensive breastfeeding charting tool was created using an electronic documentation system to assist the bedside nurse with documenting breastfeeding intervention and requesting a formal lactation consult. This documentation system allowed for tracking of exclusive breastfeeding rates and nursing interventions to increase breastfeeding rates. A lactation chalkboard was developed that centralized this documentation to allow the international board certified lactation consultants to identify patients requiring consults. Also, a central lactation phone line was created for nursing staff and physician office staff to request lactation consults from the international board certified lactation consultant team. One international board certified lactation consultant was selected for the role of clinical coordinator of lactation services, and this person coordinates phone requests and online requests from the electronic documentation system. Although, this project is still in the introductory phase, breast milk exclusivity rates for the six-hospital system have increased from 30.1% to 33.7% in 1 year.
Implications for Nursing Practice
This program identifies a multidisciplinary collaborative approach to increasing exclusive breast milk feeding rates. The end result is increasing patient and nurse satisfaction by allowing consistent evidenced-based information to be readily available to all frontline nursing staff and, thus, promoting exclusive breastfeeding.