Your Key to Improving Breastfeeding Outcomes

Purpose for the program:

The nurses from this post-partum unit with like to share their best breastfeeding practices with other similar units to help encourage and promote higher rates of exclusive breastfeeding among hospitals.

Proposed change:  

Increased exclusive breastfeeding rates are best achieved with specific, measureable, attainable, realistic, and timely goals.  This is attainable through evidence based policies, staff education/training, active nurse involvement, and collaboration of the multi-disciplinary health care team.   

Implementation, outcomes and evaluation:

In 2011, Presbyterian St. Luke’s Medical Center established a multi-disciplinary breastfeeding committee with the goal of improving exclusive breastfeeding rates.  Through the work of this committee, evidence based practice changes were implemented to promote and ensure exclusive breastfeeding including the delay of routine procedures such as vitamin K injection, providing skin-to-skin contact for the first hour after delivery, and the practices of the Colorado Can Do 5.  The committee worked diligently to update policies, educate nurses in post-partum, developed a Breastfeeding 101 presentation for labor and delivery nurses to gain their active involvement in breastfeeding after delivery, and developed breastfeeding competencies that are used in the annual skills lab.  New nurses are required to spend time with lactation consultants during their orientation, watch a skin-to-skin video, and are educated with the practices of the Colorado Can Do 5.  In addition, the committee developed consent forms for the use of donor breast milk and educated the staff.  Parents are educated about the benefits of using human milk and are encouraged to use donor milk rather than formula.  The unit purchased breastfeeding pillows and breast pumps for each patient room making breastfeeding very convenient for all mothers.  Lastly, breastfeeding is supported along the continuum of care by offering free prenatal breastfeeding classes and post-discharge support groups.

Within two years, the hospital has met and exceeded these important milestones related to exclusive breastfeeding taking the baseline exclusive breastfeeding rate of 34.1% to 85.7%.  In addition, this hospital has partnered with the Colorado Perinatal Care Council, Health Department, and pediatricians to improve the health of newborns across the state.

Implications for nursing practice:

Nurses tracked three unit outcomes including breastfeeding core measure, skin-to-skin contact, and breastfeeding documentation for each shift for a full year. This data collection enabled the team to track demonstrable evidence of ongoing breastfeeding education and incremental gains in breastfeeding success rates.  The unit continues to see improving and sustained results.

Keywords:   

breastfeeding, skin-to-skin, core measures