Dear Lactnetters:

       I am currently starting a program to get all the nurses up to par in
our small hospital (90 deliveries per month), so that all can give out
consistent information to the new parents on breastfeeding.  My unit director
is very supportive fortunately, but I want to make sure that all the
information I give is current and evidenced based so when the old nurses
resist I can come to them with current information.

Are there any pre-made care plans out there I can access?  Has anyone done
this before and would like to lean me in the right direction?  The topics I
have thought of so far are: 1. Nursing patterns for the first twenty-four
hours and then what is "normal" range for the next two days in the hospital?
2. Flat nipples- how to recognize them and what to do to work with them.  3.
Nipple shields: Friend or foe?  4.  Engorgement- how to recognize and
standard methods of treatment.  5. Pumping-when to start and how to do so
effectively without causing more harm.  6.  When is formula really necessary?
 7.  Tight frenulums and assessing suck ability.

I am sure there are a lot more, but these seem to come up most often.  My
manager said that I can include a monthly inservice and my goal is to have a
skill check list that goes with each nurses skill binder to make sure they
understand the information and how to use the equipment.

If you could email me privately I would be so appreciative.

Thanks so much

                                 Excitedly,
                                Sandi Miller, RN, IBCLC
                                San Jose, California

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