EXCLUSIVELY BREASTFEEDING NEWBORNS
Nutrition is the most critical facet in the first six months of a neonate’s life that is needed to facilitate their growth and development (Baley, 2015). The most convenient way to provide a newborn with the necessary and most desirable nutrients is through lactation. However, not all health centers educate new mothers about the importance of breast milk to the lives of their babies and that of the mother. As a result, not all neonates breastfeed within the first six months after birth which poses health-related risks to their growth and development Reevaluation of systems, support to new mothers, and proper education to mothers after delivery are the essential changes that need to be executed to help ensure that new mothers are comfortable with exclusive breastfeeding and are aware of the importance of this practice (Conde-Agudelo & Díaz-Rossello, 2014).
Change Model Overview
The ACE Star Model of Knowledge Transformation is a movement that supports the effective use of nursing interventions to enhance and uphold patients’ outcome according to the knowledge and skills being incorporated into the current systems and practices. According to Stevens (2004), the ACE Star Model of Knowledge Transformation is made up of five distinct stages which include the discovery of knowledge, evidence summary, conversion to practical recommendations, assimilation into practice, and evaluation. The application of evidence-based practices in researching patient outcomes and safety will not only help to order the formulation and implementation steps but will also enhance alignment of appropriate processes that facilitate the security of patient outcomes (Baley, 2015). Effective implementation of these stages will, in turn, go a long way to ensuring proper nutrition of both the newborns and new mothers and reduce cases of malnutrition and patient readmission.
Define the Scope of the EBP
The practice problem shown in the article, intervention to improve breastfeeding outcomes: early skin-skin contact at birth which bonds the mother and the neonatal and encourages mothers to breastfeed (Sinha et al., 2015), shows that the practice of exclusive breastfeeding is not common among many new mothers. The appalling question is on whether the new breastfeeding mothers are more likely to exclusively breastfeed when they have access to proper prenatal support and education from day one of birth compared to when they only have breastfeeding consultations after birth. Exclusive breastfeeding is a move to ensure that babies under six months are maximally breastfed to obtain the necessary nutritional requirements to enhance their well-being and bond with their mothers (Conde-Agudelo & Díaz-Rossello, 2014). Additionally, the implementation of exclusive breastfeeding program will further ensure that the population of sickly children in the children’s hospital setting reduces because of their improved immunity.
Why is this a problem? Give statistics and information to back the scope of the issue at your facility/work area.
Adequate and effective nutrition during the embryonic stage and early childhood are important for the health of a child to enable it to gain full fitness and developmental potential (Lawn et al., 2010). Breastfeeding practices are important because they provide adequate means to help curb childhood mortality and morbidity rates arising from gastrointestinal infections. Even though many mothers understand the benefits of lactation, other moms, especially new mothers lack proper knowledge regarding the importance of weaning and breastfeeding. According to the world health organization, exclusive breastfeeding refers to the practice in which infants are only fed on breast milk and not any other food or drink like water, tea, other liquids, or herbal preparations except medicines, mineral supplements, and vitamins during the whole of their first six months after birth (Sinha et al., 2015).
In research which was conducted to investigate the information about the infant feeding practices, five hundred mothers were issued with questionnaires which were used to help carry out the interview (Lawn et al., 2010). The SPSS was used for statistical analysis in which, chi-square tests helped in the evaluating the differences and relationships between variables. The study revealed that the incidence of breastfeeding practice among new mothers has increased from 72% in 1991 to around 94% in 2017. However, only 50% of new mothers exclusively breastfed their babies for the first six months while the recommended mean EBF duration is 2.10 months. Additionally, the research further revealed that 76 percent of new mothers introduced complementary feeding programs at around the 4th to the 6th month after childbirth. However, even though 61% of new moms initiate lactation and 26.1 percent of mothers breastfeed up to two years, the EBF practice among new moms for the first six months is still relatively low (Sinha et al., 2015).
Further research shows that new mothers encounter problems in meeting personal goals as well as abiding by doctor’s recommendations for continued and EBF amid augmented initiation rates (Sloan et al., 2011). Some of the barriers that impede the duration and exclusive breastfeeding process include but are not limited to alcohol consumption, type of delivery, lack of encouragement and guidance from the relevant healthcare professionals, breast problems, inadequate breastfeeding knowledge, societal limitations such as the length of maternity leave and employment requirements, and lack of societal and family support. The prevalence of one or most of these factors leads to the early introduction or use of breast milk substitutes.
How does this problem impact healthcare on a broader scale?
According to a report by the Evidence-Based Practice Center (EPC), breastfeeding offers short-term health benefits to infants by reducing the frequency of occurrence of common infections such as diarrhea, vomiting, and ear infections (Lawn et al., 2010). According to the research findings, one of every six children who was exclusively breastfed for at least six months after birth will not develop an ear problem. It then follows that of the 4 million newborns in America; nearly half of them is expected to generate an ear infection within their first six months. However, if the rates of breastfeeding in the United States are increased among new mothers to, say 80%, there would be three hundred thousand fewer cases of ear infections among children than they are today (Sinha et al., 2015).
The EPC report further indicates that the benefits of exclusive breastfeeding are not only limited to common infections that attack infants but also cater for the severe but rare illnesses. For instance, the rates of hospitalization for patients with an acute lower respiratory tract and pneumonia infection are relatively higher among the infants who were not exclusively breastfed than those who were breastfed. Furthermore, there is also a significant inverse relationship between sudden infant death syndrome (SIDS) and breastfeeding. Drawing from this finding, it then follows that the benefits of breastfeeding are not only for the good of infants but also for the future health of children and adults (Sinha et al., 2015). A proper breastfeeding history informs a significant reduction in the rates of common maladies in the later stages of development such as obesity, eczema, and decreased rates of infectious disease conditions such leukemia and type 2 diabetes. Therefore, proper breastfeeding during the early childhood developmental stages helps to reduce potential health-related complications and expenditures and promotes convenient and improved service delivery to other conditions other than avoidable ones that result from a lack of breastfeeding.
Who will you also include in your team?
It is important to select a team of employees to help in sharing ideas, research, and exploring new ideas together. For this project, I would need the OB-GYN clinic nurses, the manager of labor and delivery department, lactation consultant team, pharmacists, the nurses’ manager, the well-baby clinic nurses and myself as the team leader (Sloan et al., 2011).
The responsibility of Team Members
The chosen team is important to the project because each one of them is considered to be part of the interdisciplinary team that plays critical roles in patient care. The OB-GYN clinic nurse is the primary caregiver at the prenatal clinic and is responsible for assisting in labor and delivery as much as the provision of postpartum care to patients (Hughes, 2008). The nurses are further judged with the role to monitor fetus and the mother’s vitals before delivering and also help in the actual process of delivery. The labor and delivery department manager have the purpose of entering patient data and information into computers, monitoring patients using high-tech diagnostic equipment, and interacting on a one-on-one basis with birthing women (Lawn et al., 2010). The role of the Pharmacist is to make sure that the medical prescriptions to the patients achieve the best possible health impacts. Additionally, Pharmacists have a role in ensuring that medicines are accurate for the patient’s disease conditions to ensure that there is suppository compromise on file to confirm there are no possible drug interactions.
On the other hand, lactation consultants are responsible for educating new mothers how to breastfeed their infants (Hughes, 2008). They particularly will engage mothers who experience lactation problems such as low milk production, painful nursing, and latching difficulties. Additionally, they will extend their help to cater for infants who have problems gaining enough weight within the recommended timeframe. The Nurse Manager directs the nursing staff by providing relevant and necessary skills through continued education about the current by hospital policy. The manager further conducts staff meetings in which they discuss changes and issues that affect the nursing unit. My duty will be to provide the oversight and medical attention that require special treatment.
Evidence Conduct internal/ external search for evidence
The data is sourced from current, qualitative articles and most recommended databases for use in healthcare professionals. According to Hughes (2008), administration of medical evidence-based practice procedures states that the “five basic right of medication administration is critical for nurses and that nurses must stop, think and be vigilant when administering medication to prevent errors from occurring.” The medical errors that arise from quality improvement procedures entail a non-punitive and safe working environment which allows discussion about common mistakes, their cause, and possible prevention methods (Stevens, 2004). Introduction of simulation education would be a critical move that would help to cut on the volume, frequency, and reduction of the costs of medication errors. It will also go a long way to imparting confidence, skills, and knowledge among nurses
Recommendations for Change Based on Evidence
According to the internal and external evidence-based analysis, the project must incorporate simulation educators to help reduce and evade potential loses that result from medication administration errors (Hughes, 2008). Secondly, the plan should also factor in the element of quality and quantity assurance to maximize on the quality of service delivery to patients and reduce on the cost of production which will go a long way to promote patient’s satisfaction and maximize on profit generation (Stevens, 2004).
References
Baley, J. (2015). Skin-to-Skin Care for Term and Preterm Infants in the Neonatal ICU. Retrieved from http://pediatrics.aappublications.org/content/136/3/596
Conde-Agudelo A, & Díaz-Rossello JL. (2014). Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev. 2014;4(4):CD002771pmid:24752403
Hughes, R. (2008). Patient Safety and Quality: Evidence-Based Handbook for Nurses: New York, NY: Agency for Health Research and Quality, U.S. Department of Health and Human Services
Lawn JE, Mwansa-Kambafwile J, Horta BL, Barros FC, Cousens S. (2010). Kangaroo mother care’ to prevent neonatal deaths due to preterm birth complications. Int J Epidemiol. 2010;39(suppl 1):i144–i154pmid:20348117
Sinha, B., Chowdhury, R., Sankar, M. J., Martines, J., Taneja, S., Mazumder, S., & Bhandari, N. (2015). Interventions to improve breastfeeding outcomes: A systematic review and meta- nalysis. Acta Paediatrica, 104, 114-134. doi:10.1111/apa.13127.
Sloan, N. L., Ahmed, S., Anderson, G.C., & Moore, E. (2011). Comment on: ‘kangaroo mother care’ to prevent neonatal deaths due to pre-term birth complications. Int J Epidemiol. 2011;40(2):521–525pmid:21044980
Stevens, K.R. (2004). ACE Star Model of EBP: Knowledge Transformation. Academic Center for Evidence-Based Practice. San Antonio: The University of Texas Health Science Center
