CT DPH - CBI CPPW Project: Web Survey Questions for Maternity Staff Context: -PDA is conducting a formative process and outcomes evaluation of the CPPW - CBI project that focuses on numbers served and lessons learned. PDA is contracted by CT DPH to conduct this evaluation. -PDA has been conducting phone calls and full interviews with the participating hospitals, and will continue to work with the hospitals to obtain contact information for the trained maternity staff. Purpose: -To identify changes in practice related to the Baby Friendly steps and processes -To collect a success story related to changed maternity practices Uses for results: Respondents: Timeline: -To fulfill CDC s (the funder s) evaluation requirements -To identify promising practices for possible future replication by the CT DPH, CT Breastfeeding Initiative, other states, counties, and hospitals, and Baby Friendly USA -For CT DPH and the CT Breastfeeding Initiative to publicize successes - All trained maternity staff at each of the ten hospitals will be asked to complete a survey (~550 respondents, but we will have an internal response rate for each hospital, as well as an overall response rate). -PDA will continue to work with the hospital key staff to implement the survey to trained maternity staff. Task Date Due PDA will work with hospital contacts to coordinate web survey for Sept 19 Oct 31 nurses PDA submits a face sheet to DPH to review October 20 PDA submits draft survey to DPH for review October 27 DPH provides written or verbal feedback on survey to PDA November 2 PDA submits finalized survey to DPH November 9 PDA provides interview questions to hospital, as needed, for board November 9 review and approval PDA will implement web survey for nurses (will implement in individual hospitals as able (a few may take longer depending on board review) November 14 December 9 PDA and DPH agree on a reporting format December 18 Report due to DPH Jan 31 Prepared by Professional Data Analysts, Inc. Page 1
Methodology: Response rate: -The majority of items will be forced choice (Likert style) and may use a retrospective pre-post scale so individuals can self-report changes in maternity practices. -There will be one open-ended item where respondents will be asked to share a success story related to changes in maternity practices. -PDA staff will administer the survey using Survey Monkey. PDA will work with CT DPH to finalize all materials, and will work with the hospitals to obtain contact names and information (this will be used for survey administration only, and will not be reported in any way). -PDA staff will manage the online survey, and will send at least two reminders to non-respondents. -PDA will conduct analyze the responses using descriptive statistics for the forced choice items and thematic analysis as necessary for the success stories. -Findings will be reported in a report format agreed upon by DPH and PDA Goal is 70% at each hospital Prepared by Professional Data Analysts, Inc. Page 2
Introduction Your hospital has been working with the Connecticut Breastfeeding Initiative (CBI) to move closer to Baby-Friendly designation. You have received training related to the Baby-Friendly Hospital Initiative (BFHI). The purpose of this survey is to better understand how, if at all, your knowledge, beliefs, and/or practices have changed since receiving this training. The results of this survey will be used to better understand the outcomes of the training for maternity staff, and may be used for future project improvement. Your individual responses will remain anonymous; all reports will include only summarized information. Please complete each item in a candid manner in the next two weeks. This survey should take approximately 5-7 minutes to complete. Questions about this survey should be directed to [Melissa Haynes, or someone at the hospital provide contact information] Survey Questions TRAINING 1. Did you receive the 15-hour training for the Baby-Friendly Hospital Initiative (BFHI)? - Yes [go to question 2] - No [Skip to the before items - these individuals will be asked to respond to all items except the after set of items] 2. Who taught the 15-hour training for the Baby-Friendly Hospital Initiative (BFHI)? - I attended the training provided by the Connecticut Breastfeeding Initiative (CBI) consultant [go to question 3] - I received training from an individual at my hospital [go to question 5] - Other (please specify) 3. [if trained by the CBI consultant] Did you attend Day 1 of the training? (y/n) 4. [if trained by the CBI consultant] Did you attend Day 2 of the training? (y/n) 5. Did your hospital require you to attend the 15-hour training for the Baby-Friendly Hospital Initiative (BFHI)? (y/n) 6. Have you completed the five hours of competency training yet? - Yes - No - Don t know Prepared by Professional Data Analysts, Inc. Page 3
7. To what extent did your perceptions of the Baby-Friendly Hospital Initiative (BFHI) change after attending the 15-hour training? - I have a more positive view of the BFHI after attending the training - I have a more negative view of the BFHI after attending the training - No change from the training, I have maintained a positive view of the BFHI - No change from the training, I have maintained a negative view of the BFHI - Other (please specify): PRACTICES We would like to know more about your breastfeeding-related practices before you were trained in the Baby-Friendly Hospital Initiative (BFHI), and your breastfeeding-related practices now. First, please indicate the extent you agreed with each statement, before attending any Baby-Friendly training. Use the following scale. Strongly Agree Disagree Strongly Agree Disagree SA A D SD Not Applicable BEFORE attending the Baby-Friendly Training SA A D SD Not Applicable I was able to access and refer to the hospital s written breastfeeding policy as needed. I provided mothers with information about breastfeeding benefits and management. I facilitated mother and baby skin-to-skin contact within five minutes of a normal vaginal delivery. I typically helped mothers initiate breastfeeding during the first hour after a normal vaginal delivery. I offered all mothers further assistance with breastfeeding within six hours of delivery. I routinely taught breastfeeding mothers how to correctly latch and position their babies, and express breast milk. I did not promote infant foods or drinks other than breast milk, unless medically indicated. I encouraged mother-infant pairs to remain together (rooming-in) 24 hours a day. I knew what to say to a mother who wanted her baby to stay in the nursery. I was willing to conduct newborn procedures at the mother s bedside whenever possible. I tried not to place restrictions on the frequency and length of feedings to help mothers breastfeed on demand. I advised mothers to breastfeed their babies whenever their babies were hungry and as often as their babies wanted to breastfeed. I educated mothers on infant feeding cues such as rooting or Prepared by Professional Data Analysts, Inc. Page 4
opening and closing mouth. I explained to breastfeeding mothers why they should not give any artificial nipples or pacifiers to their babies. I provided education and resources to key family members so they could support the breastfeeding mother at home. I routinely referred mothers to breastfeeding support groups. Second, please indicate the extent you agree with each statement at the current time, after attending some or all of the Baby-Friendly training. AFTER attending the Baby-Friendly Training SA A D SD Not Applicable I am able to access and refer to the hospital s written breastfeeding policy as needed. I provide mothers with information about breastfeeding benefits and management. I facilitate mother and baby skin-to-skin contact within five minutes of a normal vaginal delivery. I typically help mothers to initiate breastfeeding during the first hour after a normal vaginal delivery. I offer all mothers further assistance with breastfeeding within six hours of delivery. I routinely teach breastfeeding mothers how to correctly latch and position their babies, and express breast milk. I do not promote infant foods or drinks other than breast milk, unless medically indicated. I encourage mother-infant pairs to remain together (rooming-in) 24 hours a day. I know what to say to a mother who wants her baby to stay in the nursery. I am willing to conduct newborn procedures at the mother s bedside whenever possible. I try not to place restrictions on the frequency and length of feedings to help mothers breastfeed on demand. I advise mothers to breastfeed their babies whenever their babies are hungry and as often as their babies want to breastfeed. I educate mothers on infant feeding cues such as rooting or opening and closing mouth. I explain to breastfeeding mothers on why they should not give any artificial nipples or pacifiers to their babies. I provide education and resources to key family members so they can support the breastfeeding mother at home. I routinely refer mothers to breastfeeding support groups. Prepared by Professional Data Analysts, Inc. Page 5
Please name two community resources for breastfeeding that you refer mothers to upon discharge from the hospital: 1. [list] 2. [list] Knowledge/Belief Questions Next, please indicate your level of confidence for each of the following actions: I can educate a patient on the relationship between rooming-in and breastfeeding exclusivity. I can quickly respond to a mother s request to send her baby to the nursery by discussing the benefits of rooming-in. I can discuss my hospital s policy to protect, promote, and support breastfeeding. I can provide reasons for not using breast milk substitutes, artificial nipples, and pacifiers. I can help a family calm their baby without the use of a pacifier. I can educate a mother on the relationship between skin-to-skin and breastfeeding initiation. I have a clear understanding of the few medical reasons for prescribing food or drink other than breast milk for babies. I understand the role of our hospital s lactation consultant. I can help a frustrated mother with early breast problems such as sore/ cracked nipples and engorgement. I can explain the advantages of breastfeeding for both mother and baby. Very confident Somewhat confident Somewhat not confident Not at all confident No Opinion Prepared by Professional Data Analysts, Inc. Page 6
Success Story We are interested in hearing successes related to the Baby-Friendly Hospital Initiative. Please provide a success story about how you implemented any of the Baby-Friendly practices at bedside. [open-ended] Areas in Need of Additional Support What additional resources, materials, or support do you need to successfully implement the Baby-Friendly Hospital Initiative? Demographics What is your current, primary position? - Registered Nurse (LPN, RN) - Nurse Practitioner (NP) - Nurse Aide/Assistant - Lactation Consultant (IBCLC) - Advanced Practice Registered Nurse (APRN) - Physician (MD) - Physician Assistant (PA) - Certified Nurse Midwife (CNM) - Other (please specify) Please indicate which hospital you are affiliated with this will only be used to report de-identified, summarized results to each hospital (as long as there are at least 15 responses). [note: we will track the hospitals and respondents using individual email addresses. There is at least one hospital that has requested use of a survey link. For that version of the survey, we will add a place for hospital name and possibly the respondent s name (for tracking purposes only)]. Prepared by Professional Data Analysts, Inc. Page 7