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 *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html