The Impact of the Gentle Transition Initiative on Exclusive Breastfeeding Rates

Monday, 30 October 2017

Felicitas Cacal, DNP, MSN, RN
Michelle Krok, BSN
Heidi Costenaro, AS
Women and Infants, Northwest Community Healthcare, Arlington Heights, IL, USA

Background: The gold standard recommended by the American Academy of Pediatrics for newborns during the first six months of life is exclusive breastfeeding.

 Local Problem: The focus for our Women and Children's Department is to foster approaches that support and encourage the initiation of breastfeeding immediately after birth and during the postpartum period. Despite the fact that quality improvement works such as skin-to-skin and minimal separation of the mothers and babies, exclusive breastfeeding rates has lagged. Joint Commission has identified exclusive in breastfeeding as one of the Core Measures (PC-O5).

 Methods: A retrospective review of the monthly and quarterly randomized data for exclusive breastfeeding was completed six months prior and six months post-implementation of the Gentle Transition initiative. Paired sample t-test statistical technique was used to determine the pre and post analysis. The data was collected using the Joint Commission Core Measures (PC-O5) for Exclusive Breastfeeding.

 Intervention: The Gentle Transition initiative comprised of delayed bathing for newborns after birth and designated quiet times for the new family was implemented to optimize best practice for the mother and baby dyads. Stakeholders and champions were identified. Research articles were shared with the stakeholders. Timeline for both projects was established. Delayed bathing was initiated first followed by the quiet time project nine months later. The theoretical frameworks used were the Iowa Evidence Based Practice and Lewin’s change models

 Results: Results of the exclusive breastfeeding rates pre-implementation were between 38%-43%. Results post implementation demonstrated a significant increase between 56%-61.5%; above thePC-05 core measure of 54.39%.

 Conclusions: The staff has implemented cost-effective interventions, which gained optimal outcome. Combined delayed bathing and quiet time quality initiatives were associated with increased in-hospital exclusive breastfeeding rates. Our ongoing journey is enhanced with additional education and enhanced practices. Leadership rounding is utilized to enhance sustainability of this important initiative.