“Where's the Lactation Consultant?!!”- Increasing Exclusive Breastfeeding Rates by Empowering L&D Nurses

Sunday, June 16, 2013

Title: “Where's the Lactation Consultant?!!”- Increasing Exclusive Breastfeeding Rates by Empowering L&D Nurses

Ryman Hall B4 (Gaylord Opryland)
Rana L. Tyson, BSN, RNC-OB , Labor and Delivery, Baylor University Medical Center, Dallas, TX

Discipline: Childbearing (CB), Newborn Care (N), Professional Issues (PI)

Learning Objectives:
  1. Identify challenges faced by L&D nurses when providing breastfeeding support after delivery.
  2. Formulate a plan to get nurses to take ownership of hands-on breastfeeding support needed in L&D rather than relying on lactation consultants.
  3. Describe methods to improve RN preparedness to provide lactation support and increase the exclusive breastfeeding rate at your institution.
Submission Description:
Purpose for the program: Breastfeeding is widely recognized as the ideal method of feeding infants.  The Surgeon General's Healthy People 2010 goal states 75% of infants will be exclusively breastfed at hospital discharge.  Currently breastfeeding rates in the United States have not met this criterion.  Baylor University Medical Center (BUMC) implemented a program focused on increasing exclusive breastfeeding rates (EBR).

Proposed change: By utilizing and equipping Labor and Delivery (L&D) nurses to be bedside breastfeeding advocates, there’s been a significant increase in BUMC's EBR, due to nurse and patient education and hands-on assistance with breastfeeding initiation.

Implementation, outcomes and evaluation: Tina Conner, IBCLC at BUMC championed a project that filled the gap in lactation support which is given to patients throughout the Women’s and Children’s service line by creating "The Crew".  The Crew consists of nurses that underwent training and committed to serving their individual unit’s needs regarding breastfeeding.  The L&D Crew is addressing barriers to breastfeeding on our unit and is implementing changes to overcome these challenges.  In particular, we re-purposed a patient breastfeeding education sheet used by the lactation department.  By adding it to our electronic system, it prints with the chart, making it readily accessible to staff.  Also, Crew members are assessing attitudes and comfort levels of L&D nurses regarding lactation support by using an online survey.  Once survey results are analyzed, in-services and staff education will be implemented, focusing on topics such as: hand-expression of colostrum and spoon-feeding, skin-to-skin contact, breastfeeding in the OR patient, use of breast pumps and breast milk storage.  Implementation of the Crew in L&D has already made an impact on our EBR, increasing it from 41% to 72%. Follow up from the online surveys will hopefully further increase the EBR rate. 

Implications for nursing practice: Increasing the EBR is a Baylor Healthcare System goal, prompted by Medicaid reimbursement policies, The Joint Commission quality measurement tools, and the Baby-Friendly designation that BUMC is working to achieve.  This innovative project of utilizing The Crew to support the L&D team will increase the EBR at our institution by empowering BUMC nurses to be champions of excellent care of women and newborns.  By exclusively breastfeeding, our patients will take part in one of the most highly effective preventative measures a mother can take to protect the health of her infant and herself.

Keywords:

Exclusive Breastfeeding

Lactation Support

Baby-Friendly

Joint Commission quality measurement

Labor and Delivery

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