Initiation of Couplet Care to Facilitate Initiation and Duration of Breastfeeding

Greenberg, Joan

Saturday, 29 October 2011

Joan Greenberg, BA, BSN, RNC-OB, CLC, IBCLC
Department of Labor and Delivery, Staten Island University Hospital, Staten Island, NY
Mary Jane Baillie, BSN, MS, RNC-OB, C-EFM, CLC
Staff Development, Staten Island University Hospital, Staten Island, NY

Learning Objective 1: The learner will be able to describe couplet care and it's association with breastfeeding outcomes through maintaining mother/baby togetherness.

Learning Objective 2: The learner will understand the process of introducing a practice change to staff.

Background: In 2006, a protocol for skin to skin contact and extended bonding was established in labor and delivery. The mother/baby dyad remain together for up to two hours under the care of one nurse. This is described in the literature as couplet care. The current practice on the maternity unit is that mother and baby are separated for admitting procedures and routine tests. Each mother and each baby are assigned to different nurses and are not cared for together. Our leadership project for the STTI Maternal Child Health Leadership Academy is to introduce the couplet care model to the maternity staff.

Purpose: To expand the couplet care model to the maternity unit in order to enhance breastfeeding outcomes, and to work toward step #7 of the WHO Baby Friendly Initiative- Practice "rooming-in" - allow mothers and babies to remain together 24 hours a day.

Methods: We planned to measure the staff nurses knowledge and perceptions of couplet care, prior to and after we provided the education on couplet care to the maternity staff. We then planned to introduce couplet care as a trial care model on the maternity unit. Our outcome measures were to assess rates of exclusive breastfeeding and the practice of rooming-in using our current data collection systems.

Results: The project was not implemented as originally planned; a trial period of couplet care was introduced using one module of the maternity unit, prior to any staff education . As a result the couplet care model of four mothers and four babies to one nurse was applied inconsistently, and the staff returned to familiar routines of practice. Rates of breastfeeding and rooming-in were unchanged. Currently, staff education is being provided and the formation of a committee, assigned to implement and sustain the couplet care model, is in progress.

See more of: Poster Session I - Maternal Child Health Leadership Academy Invited Posters
See more of: Invited Posters