In our Level II hospital, the problem was "solved" by putting the cost of pump kits, breast shells, Lansinoh, etc. into the room charge, so that theoretically all mothers are charged for these items whether they actually use them or not. This practice was in place when I came here and it is an issue I want to look at (when I have time!). Problems I have seen with this system include the handing out of equipment by the staff without the proper assessment of need. I have received some complaints from mothers who are upset that they are being given all this "stuff" that they feel they don't need and for the ones whose confidence in their ability to breastfeed is faltering anyhow, it can overwhelm them and breastfeeding goes out the window. Our nipple shields, tho, are dispensed thru out Pyxsis unit. I am responsible for keeping the drawer stocked (not pharmacy) and get a printout once a month showing who has signed out a shield for which mother. This system holds the nurse accountable for her actions - some of the staff don't like it, but I feel I am seeing some of the staff having second thoughts about giving out the shield. This system also allows the staff to get credit for their assessment skills, unlike shields being locked up in the office and dispensed at the LC's discretion. They also have to give the reason why it is being given. I'm seeing some interesting trends and am also seeing where some inservicing needs to be done. For example, the definition of "flat nipple". I'd be interested in hearing from anyone else who is using a similar system. Pam Hirsch, RN,BSN,CLC Clinical Lead, Lactation Services Advocate Good Shepherd Hospital Barrington, IL USA *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] 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