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Breastmilk Is the Best Milk!

Methodist Hospital Metropolitan (San Antonio, Texas)

CSI Summary

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CSI Presentation

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CSI Toolkit

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Project Topic:

Increasing the rate of exclusive breastfeeding by discharge from hospital

Hospital Unit(s):

Suzell Waller Women’s Pavilion

CSI Participants:

  • April Casas, BSN, RNC-NIC
  • Betty Guerrero, AAA, IBCLC
  • Corinna Perez, ADN, RN
  • Christine Silva, BSN, RNC-MNN

Project Goals/Objectives:

  1. Increase exclusive breastfeeding rate at discharge
  2. Increase pumping initiation rate for mothers with infants in the Neonatal Intensive Care Unit (NICU)
  3. Increase nurse knowledge of steps to breastfeeding initiation

Project Outcomes:

  1. Increased exclusive breastfeeding rate from 10% to 30%
  2. Increased pumping rate of NICU mothers from 71% to 80%
  3. Achieved a 100% completion rate among nurses in the Women’s Pavilion for education and return demonstration of hand expression of breastmilk

Project Overview:

At the Women’s Pavilion of Metropolitan Methodist Hospital, rates for new mothers exclusively breastfeeding at discharge were low and below the national average. Our CSI team identified various barriers and factors leading to these decreased exclusive breastfeeding rates, such as availability of breast pumps and nursing staff comfort with and knowledge about ways to support breastfeeding initiation.

We kicked off our project kicked with an educational event that demonstrated the procedure of hand expression of breastmilk with breast models and reviewed the criteria for exclusive breastfeeding. We continued educating nurses in our units in real-time on all shifts. Thank-you cards were given to nursing staff when they successfully completed a return demonstration of hand expression. Also, any nurse whose patient exclusively breastfed at discharge was entered into a drawing to win one of several gift baskets.

Since three large units were involved with the project, our CSI team advocated for and subsequently purchased two additional breast models, so that each unit had access to models for education and return demonstrations. We hosted a refresher event four months after the project’s start to encourage staff to continue exclusive breastfeeding activities with mothers. We also collaborated closely with lactation consultants to improve timely consults for NICU mothers and provide in-room breast pumps.

These strategies doubled the rate of exclusive breastfeeding in the Women’s Pavilion and increased the rate of pumping initiation 10% by new mothers in the NICU. The health benefits of exclusive breastfeeding to mothers and babies is heavily validated in neonatal literature, making this project’s impact priceless.

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The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.