DIRECTIONS 1. Refer to the guidelines for specific details on how to complete this assignment. 2. Type your answers directly into the worksheets below. 3. Submit to the Dropbox by the end of Week 3... , Sunday at 11:59 p.m. MT. 4. Post questions about this assignment to the Q & A Forum. You may also email questions to the instructor for a private response. Practice Issue Worksheet List the topic and include the citation for the systematic review you have selected: Promoting breastfeeding Sinha, B., Chowdhury, R., Sankar, M. J., Martines, J., Taneja, S., Mazumder, S., ... Bhandari, N. (2015). Interventions to improve breastfeeding outcomes: A systematic review and meta-analysis. Acta Paediatrica, 104, 114-134. doi:10.1111/apa.13127. What is the practice issue you have identified related to the topic you have chosen? In health neonates, what effect does immediate skin to skin contact have on promoting and initiating breastfeeding compared with delayed contact during a six month pilot. The facility where I work does not promote skin-to-skin immediately after delivery. After orienting on my new unit I noticed that healthy newborns were not immediately being given to the mothers after birth. Instead, they were taken away for assessment and placed in open cribs or radiant warmers. By the time they were reunited with the mother they had already been clothed and wrapped. I have noticed that many mothers want their babies to be placed on their bare skin immediately after a vaginal or cesarean section. Evidence shows that neonates who are provided immediate skin-to-skin contact initiate breastfeeding sooner and are more likely to have a successful breastfeeding experience and continue exclusive breastfeeding longer. Define the scope of the practice issue: The Registered Nurse scope of practice is to: -Support normal breastfeeding -Encourage and support mothers to breast feed when difficulties occur -Promote practices that improve breast feeding outcomes such as: initiating skin to skin contact immediately following childbirth -Refer to lactation nurse, when needed -Advocate for a breastfeeding friendly environments -Perform an assessment of mother and baby to facilitate a breastfeeding plan -Provide education on breastfeeding What is the practice area? _X Clinical Education Administration Other (List): How was the practice issue identified? (check all that apply) Difference between hospital and community practice Safety/risk management concerns Clinical practice issue is a concern _X Unsatisfactory patient outcomes Procedure or process is a time waster _X Wide variations in practice Clinical practice issue has no scientific base Significant financial concerns _X_ Other: Patient preferences Describe the rationale for your checked selections: -Some patients are complaining that there is no immediate bonding or skin to skin contact initiated with their newborns allowing for the natural innate newborn behavior of breastfeeding -There is little education provided about the importance and benefits of breastfeeding - Newborns of mothers whom exclusively want to breastfeed are given supplemental feeds which discourages breastfeeding in both the neonate and the mother - Breastfeeding mothers complain that they are being given gift packs containing samples of infant formula. This gives them conflicting messages on when to initiate breastfeeding, exclusivity of breastfeeding, and continuity of breast feeding. -Mothers and infants are being separated during their hospital stay, i.e. nursery care -Cesarean sections are delaying skin to skin contact between mothers and their infants -Skin to skin contact (SSC) improves infant outcomes with respect to SCRIP score, blood glucose levels, and infant thermoregulation - Optimal breastfeeding practices are attributed to reducing more than 10% of deaths in children under 5 annually. What evidence must be gathered? (check all that apply) _X_ Literature search Clinical Expertise _X Guidelines Financial Analysis Expert Opinion Standards (Regulatory, professional, community) _X Patient Preferences Other Describe the rationale for your checked selections: - Literature research, in the form of systematic or meta-analysis, gives you access to a larger sample and information that has already been analyzed. In essence it lets you get to the evidence quicker. - Guidelines from organizations like the World Health Organization and the Centers for Disease [Show More]
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