Date Available

12-12-2024

Year of Publication

2024

Degree Name

Doctor of Nursing Practice

Advisor

Dr. Leslie Scott

Committee Member

Dr. Lisa McGee

Committee Member

Dr. Holly Chitwood

Abstract

Background: The benefits of breastfeeding for both mother and baby are known. It is recommended that all infants be exclusively breastfed until six months (Meek & Noble, 2022; North et al., 2021). Despite this, breastfeeding rates remain low, especially in medically fragile infants requiring care in the neonatal intensive care unit (NICU) (Rollins et al., 2016). Receipt of evidence-based breastfeeding support by healthcare providers has been shown to improve breastfeeding success; however, many healthcare providers report not being comfortable or knowledgeable enough to offer support consistently (Mulcahy et al., 2022; Rollins et al., 2016).

Purpose: This study aims to determine how education on unit-specific evidence-based breastfeeding support standards impacted knowledge and self-efficacy of NICU nurses and breastfeeding rates at discharge from the NICU.

Design: Pre- and Post-Survey Quasi-Experimental Design

Methods: The study utilized a pre-and post-survey quasi-experimental design. NICU nurses were educated regarding existing evidence-based unit standards for breastfeeding support. Following the educational session, they also received a printed reference tool with a QR code that linked to the unit’s breastfeeding support standards and evidence. A questionnaire was used to measure nurses’ knowledge level and self-efficacy regarding breastfeeding support immediately before the educational session and again four weeks after the session. Overall breastfeeding rates at discharge from the NICU, breastfeeding education frequency, and adoption of evidence-based breastfeeding support measures were obtained using a prospective and retrospective chart review. Pre- and post-intervention survey results and chart review data were compared and analyzed. The self-efficacy questions, knowledge questions, and chart data were compared and analyzed separately with appropriate statistical tests, including paired t-tests, frequencies, and chi-square tests.

Results: There were improvements in both knowledge and self-efficacy after the intervention. Total knowledge scores out of ten increased significantly (p = .002) as did total self-efficacy scores (p = .001). There was no significant change in the patient’s breastfeeding feeding status at discharge or any other electronic health record metric.

Conclusions: Educational interventions can effectively improve knowledge and self-efficacy regarding breastfeeding support. Education can improve knowledge level, which impacts overall self-efficacy to provide breastfeeding support. Continued data collection is required to determine if the educational intervention impacts the patient’s feeding outcomes.

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