The Role of Stakeholder Engagement and Interdisciplinary Collaboration in an Evidenced-Based Practice Program to Promote and Support Breastfeeding

Damstra, Kelli M.

Friday, April 12, 2013

Kelli M. Damstra, DNP, MSN, RN
Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, MI
Linda D. Scott, PhD, RN, NEA-BC, FAAN
School of Nursing- Health Systems Science, University of Illinois at Chicago, Chicago, IL, Chicago, IL

Learning Objective 1: The learner will be able to describe how strategic leadership and interdisciplinary collaboration are necessary before embarking upon a systems-level change such as the BFHI.

Learning Objective 2: The learner will be able to identify the interdisciplinary roles of healthcare members in providing breastfeeding education and support to improve health outcomes.

Evidence from the literature overwhelmingly indicates that breastfeeding is globally accepted as the gold standard for infant nutrition and is the optimal choice of feeding. Focusing on efforts to support and promote breastfeeding through following recommendations of evidence-based practices such as the Baby-Friendly Hospital Initiative (BFHI) is an effective way to target the existing low breastfeeding rates and improve health outcomes. The purpose of this practice dissertation project was to work in collaboration with a community hospital on the BFHI designation pathway by specifically implementing breastfeeding education (Step three of the guidelines).

Using the conceptual frameworks of both Donabedian and Breastfeeding Self-Efficacy theory, a multi-faceted approach was implemented targeting all pregnant women in this organization’s affiliated prenatal clinic. Helping to create transformational change in organizational culture at the system level resulted in the development of the prenatal educational program (PEP). Healthcare providers and office staff delivered breastfeeding education and support to patients as a component of their routine care.

Preliminary evaluation of the PEP did not indicate that there was a difference in the short-term outcomes of breastfeeding knowledge, self-efficacy, and intent. However, significant differences were found in both the pre-intervention and post-intervention assessments in that women who planned to breastfeed had higher confidence in breastfeeding knowledge and self-efficacy when compared to women who were undecided or did not intend to breastfeed.

Practice implications exist related to interdisciplinary collaboration, strategic leadership, and systems change. A fundamental component of implementation science is that leadership engagement is a crucial factor because of the commitment, involvement, and accountability that influences the execution of a systems-level change such as the BFHI. Engagement of key stakeholders was instrumental in facilitating an organizational climate ready for implementation of evidence-based practices to provide breastfeeding education and support, and to improve health outcomes at the community level.

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