Actually, I have been working on this issue of lack of continuity of 
care from hospital to outpt setting.
      I received a grant in the fall to develop a 'Office-Nurse 
Breastfeeding Champion' curriculum, 16 hours of training. The goal is to 
train 1 RN in each primary care office in our University of Wisconsin 
Medical system (23 nurses at this point) to become expert breastfeeding 
triage nurses, and to teach them certain skills, such as how to teach 
pump use, how to look at a latch, how to look at a growth curve, and how 
to do pre-post feed weights. Most of what I am teaching is expert 
triage, so that they know what to advise parents when they call, steps 
parents can take before an appt with an LC or mom/baby provider.  They 
would basically be assistants to LCs. I don't think the lactation 
educator program fits the bill because office nurses need very specific 
triage skills. The curriculum comes with electronic medical record tools 
for triage, designed for EPIC.
We start our curriculum in a week, and we are all very excited. I feel 
that this would help to close that gap from the hospital to the medical 
home. We plan to teach the hospital nurses and LCs about the nurse 
champions, so that they can refer moms with problems to the nurse 
champion right away, so the nurse champion can triage care for the dyad.
Anne

Anne Eglash MD, FABM, IBCLC
Clinical Professor
Dept of Family Medicine
Medical Director UW Lactation Clinic
University of Wisconsin School of Medicine and Public Health
600 N. 8th St.
Mount Horeb, WI, 53572
608-437-3064 (O)
608-437-4542 (fax)
608-550-3054 (pager)
On 2/24/2013 9:56 AM, Norma Ritter wrote:
> Anne wrote:
> >Hospital staff are not managing these moms and babies over the next 
> few years like I am, so they don't see the long-term impact of
> handing out these shields.<
>
> This, to me, is crux of the matter,
> Hospital staff, including IBCLCs, are rarely able to spend more than a 
> few minutes with each patient, and the nipple shield is the quick fix. 
> Even when adequate teaching is done with regard to monitoring the 
> baby's intake, knowing how and when to discard the shield and so on, 
> there is rarely follow up after discharge.
>
> What we need is more coordination between in-hospital and outpatient 
> resources. Of course this is one of the steps of the Baby Friendly 
> Initiative, that mothers be referred to appropriate resources on 
> discharge. And this is where both private practice IBCLCs and mother 
> to mother groups come in.
>
> Norma Ritter, Breastfeeding USA Counselor, IBCLC, RLC
> BreastfeedingUSA.org <http://BreastfeedingUSA.org>
> www.NormaRitter.com <http://www.NormaRitter.com>
>


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