Computer resources for staff education in long-term care

Abstract

Louisiana (LA) breastfeeding rates are among the lowest in the United States, and associated infant mortality and morbidity rates are among the highest. To increase the knowledge of maternity nursing staff regarding breastfeeding and improve attitudes towards implementing evidence‐based maternity practices that facilitate breastfeeding, a six contact‐hour program promoting LA's breastfeeding initiative, The Guided Infant Feeding Techniques (GIFT) was developed. The 10 steps of GIFT are based on the Baby Friendly USA Ten Steps to Successful Breastfeeding with maternity nursing staff education identified as a critical component.To increase staff knowledge and improve attitudes and self‐efficacy of nurses in implementing the criteria for GIFT hospital certification, which is a stepping stone to Baby Friendly designation.The GIFT nursing staff program “Promoting Evidence‐Based Breastfeeding Support in Louisiana: The GIFT” was presented to 1086 participants in 35 hospitals across LA from November 2008 to February 2012.Pretests and identical posttests were provided. Posttest scores were significantly higher after each session in each program (p < .01). The mean score of each LA public health region posttest was greater than 95%, which is an increase of more than 25% from pretest scores. Participant evaluations identified positive ratings for the program having increased knowledge, changed a skill or an attitude, enhanced practice performance, and improved customer service. Descriptive analysis of responses to open‐ended evaluation statements indicated increased intention to implement strategies promoting evidence‐based maternity practices. Within 30 months after the program, the number of GIFT‐certified hospitals had increased from nine to 24 of the 53 maternity hospitals in Louisiana. Louisiana breastfeeding rates and national rankings by the Centers for Disease Control and Prevention (CDC) Breastfeeding Report card have increased from 2007 (year before the education program) to 2013 (year after the education program ended) although they remain (in four of five Healthy People 2020 goal categories) in the lowest quartile of the United States.Program strengths, as reported by participants, include convenience and minimal expense in time and money. Programs repeated in each region allow increased same‐hospital staff attendance. The development of webinar programs and train‐the‐trainer programs are being explored as future options.Breastfeeding programs such as the GIFT nursing staff education program will potentially increase knowledge, intention, and advocacy for increased implementation of evidence‐based maternity practices that increase breastfeeding rates to improve outcomes for infants and women.