Shawna Helmuth BS, RN, IBCLC, RLC Lactation Services Salinas Valley Memorial Healthcare System Salinas CA
Non disclosure I have no actual or potential declarations in relation to this program
Outline Hospital goal Baby Friendly Hospital Initiative Challenges for our hospital Policy & practice Evaluating outcomes and follow-up over time
Community hospital SVMH 269 beds, 28 maternal beds 1760 deliveries per year Women & Children s service director change over last 11 years
Hospital Goal Community shift to improve BF rates Local coalitions goal to assist all county hospitals to become BFH LC position, BFHI, change in hospital culture
Quest for Baby Friendly Board members approval for letter of intent 2005 actually began multidisciplinary task force look at processes and practices, go over goal for the year Lining up physician advocates from each specialty (OB, FP, PEDS)
Step 6 Give infants no food or drink other than breast milk, unless medically indicated Materials for patient use Does not accept free or subsidized supplies of breast milk substitutes, nipples or pacifiers
Patient Education materials Free of company logos Appropriate handouts for each family Staff use and consistent message to mother and family
Is it really free? Why do it? Purchasing formula It is all related to becoming Baby Friendly or about improving the health of the infant and family?
Fear of change Formula representatives commonly come to the unit and stock formula and leave gifts (lanyards, pens, cups, lunch boxes, etc) or articles for staff to read Purchasing formula No give away items How the community views your hospital
Evaluating Current Practice Staff EBP Formula Use Physicians Purchasing
Staff buy-in Who does it affect Why are we doing it What do we (hospital and staff) get out of it
Physician buy-in What are the actual medical indications for formula supplementation Non-medical indications for formula supplements Evidence based practice?
Physician Education What tools will assist you in getting the message to the physician and the physician reading it (BFHI parameters for education) Keeping current information moving forward
Evidence based Practice Convey message to all involved How to get support and feel comfortable with message we are sending
Diaper Bag give-away
Staff concerns: Parents can t afford a diaper bag, wee need to give something away, nothing wrong with the bag it s free What message are you trying to convey Will it really matter to the patients? Our motto was We don t participate in that program. Explained to parents they can call the company and order one
Paying for Infant Formula
Community practice There was a noticeable increase in formula reps going to local physician offices Formula displayed on counters
Company representatives coming freely to the maternity unit
Practice Change Education materials from a variety of companies
Hospital based education materials Don t reinvent the wheel Use handouts that are appropriate and abide by the WHO code Ask permission to use other institution handouts and give them credit for it
Policy & Practice Change
Hospital wide approach Purchasing department Gift shop Photos depicted at the hopsital First photo company and materials handed out CBE classes, BF classes
Performance Improvement Behavior & Practice Staff & Physician practice change Chart Review Handouts to provide consistent education Patient Education
Practice Change Chart review Patient surveys Watching staff practice Physician change in practice
Bibliography Baby Friendly USA. 2011. Retrieved online 12/30/2011 from http://www.babyfriendlyusa.org. BantheBags.org. 2011. Retrieved online 12/30/2011 from http://www.banthebags.org Massachusetts Breastfeeding Coalition. 2011. Retrieved online 12/30/2011 form http://www.massbreastfeeding.org. Salinas Valley Memorial Healthcare System. 2011. Facility policy and practice. World Health Organization. 2011. Retrieved online 12/30/2011 from http://www.who.int. Shawna@svmh.com, 831-757-4333 ext. 2852