I have to admit, I'm following this one with some reservations and will
try to share what I can.
First of all, check out the AWHONN publication "Competence Validation
for Perinatal Care Providers." It is a wonderful resource for all kinds
of orientation, continuing ed and evaluation ideas. Breastfeeding is
covered and several health care institutions have kindly shared their
lists. Here in Chicago, you may think we are progressive but not at
Mount Sinai (low income, minority, non-English speaking patient
population) . Before I started here in 1998, there was NO breastfeeding
program or formal education given to staff or patients. That is a whole
'nother story which I will be sharing in a poster session at ILCA this
year. All of the information I will share concerns the maternal-child
area; mother-baby unit, NICU, Labor & Delivery and Pediatrics.
Anyway, our breastfeeding competencies are also our orientation
checklist for new staff and these are offered four times per year or as
new staff is hired. All RNs and CNAs and unit secretaries are expected
to be able to demonstrate these. I also have a dandy little 10 question
quiz that is given as a post-test. Staff must score 80% to pass.
Items included are: identify, list, or describe: optimal time for
initiation of breastfeeding, frequency & duration of feeding, potential
effects fo supplemental water or formula in the breastfeeding infant and
mother, signs of adequate breast milk/colostrum intake, aspects of
proper postioning and latch-on, causes/interventions for sore nipples,
causes/interventions for engorgement. Breast pumps and other devices are
addressed as well: indications for use of a manual or electric breast
pump, assembly of both, indications/interventions for flat or inverted
nipples, and use of breast shells. Return demonstration is required and
they need to view the breastfeeding videos we use for patients. Another
competency is the ability to locate patient education
materials/professional resources and they have to read the AAP statement
(12/97) and the "Review of Medical Benefits and Contraindications to
Breastfeeding in the US" (Lawrence document). The quiz covers all of
those resources.
This year I started an article review "contest" and it seems to be
popular. I distribute an article monthly, including 5-6 short questions
and give small prizes to those who turn in a quiz with all correct
answers. I am using very basic articles that LCs are familiar with but
that our staff may not be aware of. This month's article is Righard's
"effect of delivery room routines" from Lancet, 1990. last month, I
used a LLL Fact sheet (very short and sweet). I had 24 responses! I use
little things like nice pens, tubes of hand lotion, small sample sizes
of bath products and other stuff I can get for $1-2-3 each. Staff is
asking questions and suggesting articles. The small effort seems to be
paying off!
Hope this is helpful to you.
Mary Kay Smith, IBCLC
Romeoville IL near Chicago
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