I have used several different tools/methods over the years.  New hires are 
assigned to spend one day during their orientation with me.  I developed 
and use a checklist for all the "hands on skills" that they are expected to 
know/use at the bedside.  One side is the mechanics (position/latch, etc.) 
of breastfeeding, troubleshooting problems, including when and how to offer 
lanolin, shells, etc.  The second side is pump set-up, mom education, milk 
storage, etc.  All the staff has been competencied on this and I will, as 
the need arises, re-inservice and re-test.  One year we used the Case 
Western Reserve/March of Dimes on-line computer competency.  It was 
generally well-received with most of the staff feeling like they learned a 
lot.  We did have some unforseen issues with the computer method.  I made 
the mistake that assuming there was NO one with computer skills as non-
existent as my kids tell me mine are - we discovered that many of our staff 
are not very computer literate and consequently some scores, etc. were not 
recorded due to improper registration/log-on.  The competency is a good 
overview of the basics, is FREE! and CME's can be earned.
This year I am planning on using a hard copy competency developed by an 
IBCLC at one of our sister hospitals that requires some reading and viewing 
of videos, as well as policy review in order to complete the test.
I am using the MOD breastfeeding module developed by Marie Biancuzzo in 
training my 5 staff nurses who are interested in sitting the exam next 
year.  The cost is $20/nurse with CEU's earned.
The staff is required to do one breastfeeding competency/year which is why 
I have used a variety of modalities.  Otherwise, I think we would all get 
bored!

Pam Hirsch, BSN,RN,IBCLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hosital
Barrington, IL  USA

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