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BREASTFEEDING FRIENDLY GUIDELINES AND EVALUATION CRITERIA
for community health centers and
- utpatient care settings
AND EVALUATION CRITERIA for community health centers and outpatient - - PowerPoint PPT Presentation
AND EVALUATION CRITERIA for community health centers and outpatient - - PowerPoint PPT Presentation
BREASTFEEDING FRIENDLY GUIDELINES AND EVALUATION CRITERIA for community health centers and outpatient care settings Expert Advisory Board Expert Advisory Board met for 10 months bimonthly We looked at Joint Meeting April 30 th , 2013
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Expert Advisory Board met for 10 months bimonthly
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We looked at…
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Joint Meeting April 30th, 2013
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Breastfeeding-Friendly Guidelines and Evaluation Criteria for Community Health Centers and Outpatient Care Settings
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STEP 1: POLICY AND PROTOCOLS
Establish and routinely communicate to all clinic staff a written feeding policy that promotes, supports and protects breastfeeding and human milk as the normative standard for infant feeding and nutrition.
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Policy and Protocols Guidelines
- 1. Develop policy
- 2. Communicate policy
- 3. Display policy
- 4. Create and implement
protocols
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STEP 2: STAFF EDUCATION AND EVALUATION
Provide initial and ongoing competency-based education and training for all clinic staff on topics necessary to establish and maintain the infant feeding policy and protocols that support delivery of comprehensive breastfeeding education and clinical services.
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- Guidelines feature:
- Assess staff training needs
- Develop training plans
- Implement competency based
education and training
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- Guidelines also feature:
- Evaluate clinical-based
infant feeding and breastfeeding skills
- Have access to a
breastfeeding expert
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- Criteria for
Evaluation
- Written training
plans
- Staff training
timeline
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- Other criteria for evaluation
- Training records with:
- Timeline for skills evaluation
- Appropriate skills for area of clinical
practice
- Documented access to a breastfeeding
expert
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STEP 3: INFANT FEEDING EDUCATION
Provide accurate and evidence-based information about breastfeeding and human milk to all pregnant women, mothers and/or caretakers that is based on current nationally recognized guidelines.
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- Guidelines feature:
- Encouragement to exclusively
breastfeed or feed infants only human milk
- Review of normal infant
behaviors: sleep, crying, and infant feeding cues
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- Guidelines also feature:
- Differences in breastfeeding, human
milk and artificial milk (formula)
- Dyad’s health and developmental
benefits of breastfeeding and human milk
- Management of successful
breastfeeding
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- Criteria for evaluation:
- Written information provided as
education
- Documentation of patient reporting
services provided
- Documentation of educational
encounters, in medical records
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In Conclusion
- These steps align with this
learning objective:
- Communicate expectation to all
staff using skills-based competencies appropriate to training and role in patient care.
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STEP 4: CLINICAL SERVICES
Provide clinical services that promote and support breastfeeding for the mother-baby dyad as optimal infant feeding and nutrition.
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STEP 5: CLINICAL ENVIRONMENT
Establish, provide, and maintain a breastfeeding- friendly clinic environment.
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STEP 6: COMMUNITY RESOURCES
Collaborate with local agencies and health professionals to ensure continuity of care and breastfeeding support in the community.
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STEP 7: WORKPLACE LACTATION ACCOMMODATIONS
Provide and maintain effective lactation accommodation for all employees within the
- rganization.
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- Department of Health and Human
Services has recognized that there are “alarming” disparities in breastfeeding rates across racial and socio-economic lines
- The Centers for Disease Control and
Prevention (CDC) has also found that 60% of women cannot even meet their own breastfeeding goals
Melissa Bartick, MD, MSc and Marsha Walker, RN, IBCLC - USBC 2011
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Where are the disparities?
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75% 74% 83% 81% 58% 43% 42% 56% 46% 28% 22% 21% 33% 25% 13% 0% 20% 40% 60% 80% 100% United States American Indian or Alaska Native Asian or Pacific Islander Hispanic or Latino Non-Hispanic Black or African American
Provisional Breastfeeding Rates Among Children Born in 2007
Breastfeeding at 12 Months (%) Breastfeeding at 6 Months (%) Ever Breastfed (%)
U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Support Breastfeeding. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General; 2011.
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California breastfeeding rates by race/ethnicity 2011
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Baby-Friendly vs. traditional
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High breastfeeding=low Medi-Cal
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Why do the disparities exist?
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Labbok M, Taylor E. Achieving Exclusive Breastfeeding in the United States: Findings and
- Recommendations. Washington, DC: United States Breastfeeding Committee; 2008.
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STEP 8: FINANCIAL SUSTAINABILITY
Develop a financial plan that guides provision of breastfeeding services in a way that maximizes sustainability in the context of overall health services and resources provided.
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Financial Sustainability
- Financial plan
- Support for billing codes
- Incorporation of financial
planning for lactation services into the EHR
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Auditing
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STEP 9: QUALITY IMPROVEMENT AND IMPACT EVALUATION
Establish systems of data tracking, quality assurance, continuous quality improvement and impact evaluation.
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Quality Improvement
- Maternal-infant feeding outcomes
- Referrals to IBCLCs as appropriate
- Evidence of collaboration with WIC,
regional and statewide agencies
- Comparisons of clinic data with
published data
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