Objective:  Will an educational intervention increase knowledge and positively influence attitudes in Birthing Center staff in regards to maternity care practices related to the Baby-Friendly Hospital Initiative (BFHI)?  This intervention will serve as a foundational step to prepare our hospital for the journey toward BFHI designation.

Design: This study used a pretest-postest quasi experimental design with the target population healthcare practitioners in facilites which provide maternity care services.

Setting: The accessible study population consisted of Birthing Center staff in a rural community hospital .

Patients/Participants: The study participants consisted of eight pediatricians, four obstetricians, and 28 nurses.  Included in the nurses group were three nursing students and four obstetric technicians.

Methods: The pre and posttest knowledge/attitude survey tool was an investigator developed tool. The survey tool items were developed in accordance with the Baby-Friendly Hospital Initiative “10 Steps to Successful Breastfeeding” which was developed by the World Health Organization and UNICEF in 1989. Content validity of the survey tool was verified by expert staff from the BFHI. A paired-samples t-test using pre and post test survey results was conducted on each individual survey item to evaluate the impact of the educational intervention on the understanding of and attitudes about maternity care practices consistent with the BFHI. The eta squared statistic were calculated for effect size.

Results: On the survey’s 10 knowledge questions, the average overall pretest score was 76 %. This increased to 95 % following the staff training. Of these 10 questions, further analysis demonstrated that five of the questions did not meet criteria for statistical significance when calculated separately but when combined had a pretest score of 97 % and a posttest score of 98.5%.  On questions 3, 6, 7, 8, and 9, the percentage correct was high on both pre and posttests indicating either foreknowledge or a simplistic question.  The remaining five questions demonstrated strong statistical significance with a combined mean p<.01 indicating the effectiveness of the training on the participants knowledge. On the Likert scale questions concerning attitude with 1 representing strongly disagree and 5 representing strongly agree, the pretest mean score was 3.84, increasing to 4.53 following the intervention.  This increase carries a p<.0012, indicating a strongly significant increase in positive attitude toward BFHI maternity care practices.

Conclusion/Implications for nursing practice: Our findings indicate a significant impact on knowledge and attitude about BFHI consistent maternity care practices when healthcare staff is provided with targeted education.

Keywords:  Baby-Friendly Hospital Initiative, Perinatal Care Measures, Surgeon General.