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Improving breastfeeding initiation p...

Weddig, Jennifer.

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Improving breastfeeding initiation practices of registered nurses through online theory-based education.

紀錄類型:	書目-語言資料,印刷品 : Monograph/item
正題名/作者:	Improving breastfeeding initiation practices of registered nurses through online theory-based education./
作者:	Weddig, Jennifer.
面頁冊數:	184 p.
附註:	Source: Dissertation Abstracts International, Volume: 72-08, Section: B, page: .
Contained By:	Dissertation Abstracts International72-08B.
標題:	Health Sciences, Obstetrics and Gynecology. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3454649
ISBN:	9781124645100

Improving breastfeeding initiation practices of registered nurses through online theory-based education.
Weddig, Jennifer.

Improving breastfeeding initiation practices of registered nurses through online theory-based education. - 184 p.

Source: Dissertation Abstracts International, Volume: 72-08, Section: B, page: .

Thesis (Ph.D.)--Colorado State University, 2011.

The benefits of breastfeeding are clearly established (Ip, Chung, & Raman, 2007), yet couplets in the United States (US) and in Colorado do not meet many of the Healthy People 2010 goals for breastfeeding duration. Hospitals that perform evidence-based best practices related to breastfeeding can improve breastfeeding initiation rates, rates of exclusive breastfeeding at time of hospital discharge, and possibly breastfeeding duration rates (Broadfoot, Britten, Tappin, & MacKenzie, 2005; Manganaro et al., 2009). One of the reasons that mothers report discontinuing breastfeeding is that they receive conflicting messages from healthcare providers.

ISBN: 9781124645100Subjects--Topical Terms:

1020690
Health Sciences, Obstetrics and Gynecology.

Improving breastfeeding initiation practices of registered nurses through online theory-based education.
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100 1 $a Weddig, Jennifer. $3 1679822
245 1 0 $a Improving breastfeeding initiation practices of registered nurses through online theory-based education.
300 $a 184 p.
500 $a Source: Dissertation Abstracts International, Volume: 72-08, Section: B, page: .
500 $a Advisers: Garry Auld; Susan Baker.
502 $a Thesis (Ph.D.)--Colorado State University, 2011.
520 $a The benefits of breastfeeding are clearly established (Ip, Chung, & Raman, 2007), yet couplets in the United States (US) and in Colorado do not meet many of the Healthy People 2010 goals for breastfeeding duration. Hospitals that perform evidence-based best practices related to breastfeeding can improve breastfeeding initiation rates, rates of exclusive breastfeeding at time of hospital discharge, and possibly breastfeeding duration rates (Broadfoot, Britten, Tappin, & MacKenzie, 2005; Manganaro et al., 2009). One of the reasons that mothers report discontinuing breastfeeding is that they receive conflicting messages from healthcare providers.
520 $a A knowledge deficit exists in practicing registered nurses (Chiu, Gau, Kuo, & Chung, 2003; Holaday, Karipis, & Spicer, 1999), and the amount of didactic and clinical breastfeeding education provided in undergraduate nursing programs is not adequate (Spear, 2006). Lack of adequate evidenced-based knowledge content in obstetric nursing courses can lead to a knowledge deficit related to breastfeeding best practices (Hellings & Howe, 2004). This knowledge deficit can lead to inconsistent advice given to mothers when the student nurse becomes a practicing registered nurse (RN).
520 $a Additional education related to breastfeeding initiation best practices is needed for registered nurses. Currently, very few courses that are available for nursing students and registered nurses that adequately cover the topic of breastfeeding. Because the schedules of hospital-based registered nurses vary, online education presents a unique opportunity to provide continuing education (Chang, Hsiao Sheen, Chang, & Lee, 2008; Wilkinson, Forbes, Bloomfield, & Fincham Gee, 2004).
520 $a Objective. Phase I: Focus groups were conducted to assess the variation in breastfeeding knowledge and practices of registered nurses working in hospital maternity units and the informal and formal hospital policies related to the initiation and support of breastfeeding.
520 $a Phase II: The focus group data were used to create a one-credit online course for registered nurses in breastfeeding best practices targeting hospital-based registered nurses. The objective of the second phase of the study was to determine if a one-credit online course (with an eight-hour, in-person practicum) results in changes in the knowledge and behaviors of hospital-based registered nurses in relation to breastfeeding initiation best practices.
520 $a Design. This was a mixed-methods study. Qualitative focus group data were collected about perceptions of hospital-based registered nurses regarding breastfeeding best practices. These data were used to develop an online course with an eight-hour practicum designed to increase registered nurses knowledge and improve behavior in the area of breastfeeding initiation. Data were collected from treatment and comparison groups before and after the course and the practicum to assess change in knowledge and behavior.
520 $a Interviews were conducted with management teams at three Colorado hospitals 12 months after registered nurses in those hospitals completed the online course in order to assess perceptions of changes that had occurred as related to breastfeeding initiation policies and best practices.
520 $a Participants. Forty female registered nurses from labor and delivery (n=9), postpartum (n=13), labor and delivery/ recovery/ postpartum care (LDRP) (n=12), and neonatal intensive care units (NICU) (n=6) comprised eight focus groups. In the intervention, 45 female registered nurses participated in the comparison group, and 50 female registered nurses comprised the treatment group.
520 $a Results. According to the focus group data, the majority of registered nurses reported being knowledgeable of evidence-based best practices related to breastfeeding initiation. However, in non-Baby Friendly/ Baby Friendly Intent Hospitals (non-BF/BFI), nurses knowledge often was not in accordance with current best practices in breastfeeding initiation, and reported hospital policies were not based upon evidence-based practices. Barriers to best practices in breastfeeding initiation included hospital lactation policies (formal and informal), registered nurses' limited knowledge in breastfeeding initiation best practices, high rates of surgical delivery, and lack of continuity of care with the transition of responsibility from one nurse to another from labor and delivery to transition care to postpartum care.
520 $a According to the data from the three data collection tools used in the second phase of the research, registered nurses in the treatment group demonstrated an increase in knowledge; however, there was very little change in nursing behaviors. There were statistically significant changes in registered nurses behaviors related to appropriate use of formula supplementation as evidenced by the chart review (p<.05).
520 $a Results of the management interviews indicate two out of three hospitals had policy and procedure changes during the 12 months after completing the online course. A significant disparity between nurses' intention to support breastfeeding and their knowledge suggests there is a need for education based on the World Health Organization Baby Friendly standards for registered nurses at non-BF/BFI hospitals. A significant barrier to supporting breastfeeding is a lack of hospital policy and/or inappropriate or outdated policy. The online course produced changes in knowledge, but change in behavior did not occur as predicted. This is likely due to existing hospital policy and culture that must change in order to support breastfeeding initiation best practices. Once policy was changed, registered nurses were able to make behavior changes. The establishment of breastfeeding policies allowed the environment of best practices to remain the norm even as registered nurses or nurse managers are replaced by other registered nurses.
590 $a School code: 0053.
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710 2 $a Colorado State University. $b Food Science & Human Nutrition. $3 1676397
773 0 $t Dissertation Abstracts International $g 72-08B.
790 1 0 $a Auld, Garry, $e advisor
790 1 0 $a Baker, Susan, $e advisor
790 1 0 $a Quick, Don $e committee member
790 1 0 $a Horodynski, Mildred $e committee member
790 $a 0053
791 $a Ph.D.
792 $a 2011
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3454649