Mcn-The American Journal of Maternal-Child Nursing最新文献

Purpose: Describe the implementation of trauma-informed care education and the attitudes toward trauma-informed care among birth workers in Maryland.

Study design and methods: Cross-sectional descriptive study of health care professionals involved in the childbirth continuum of care in Maryland. Data collection was conducted between January 11th and February 23rd, 2024 as a pre-survey to a grant-sponsored trauma-informed care education program. The Attitudes Related to Trauma-Informed Care (ARTIC) scale was used to quantify participants' trauma-informed care attitudes.

Results: There were 220 participants in the educational sessions, 111 of whom met inclusion criteria and participated in the survey. The ARTIC scale had a mean of 5.38 (SD 0.7) across all participants, scores ranged from 2.16 to 6.51, indicating receptive birth worker attitudes toward trauma-informed care. Lowest sub-scale scores were for understanding the underlying causes of trauma and identifying adequate system support for trauma-informed care. There were significant differences in ARTIC scores between nurse participants (M 5.34, SD = 0.51) and those in other roles (M 5.6, SD = 0.58), with nurses exhibiting lower scores (p = .035).

Clinical implications: Maryland perinatal professionals are receptive to trauma-informed care practices and would benefit from targeted education to more fully understand the underlying causes of trauma and initiation of a universal approach to trauma-informed care. Health care leaders should demonstrate their commitment to trauma-informed care by providing team members who care for women during childbirth with increased resources, education, and support for this care model.

Purpose: To examine whether hospital variation in the nurse work environment during labor and birth is associated with variation in the rate of exclusive breast milk feeding during the birth hospitalization.

Study design and methods: Cross-sectional analysis of nurse survey, hospital, and exclusive breast milk feeding outcome data in a sample of 258 hospitals in five states. Sequential multivariate linear regression models were used to model the relationship between the outcome of exclusive breast milk feeding and the nurse work environment.

Results: A good or mixed nurse work environment is significantly ssociated with higher hospital-level exclusive breast milk feeding rates in unadjusted and adjusted regression models. A hospital's Baby-Friendly status was not significantly associated with exclusive breast milk feeding rates.

Clinical implications: Improvements to nurses' work environments can potentially increase hospital-level exclusive breast milk feeding rates.

Abstract: The first well-child encounter for healthy, full-term newborns occurs within the critical window for the establishment of the milk supply. Frequent, effective removal of human milk from the breast is essential to achieving a robust milk supply. Nurses in primary care settings are crucial in providing quality and timely lactation care to ensure the parent is experiencing effective milk removal. Identification of risk factors and barriers to achieving a milk supply requires adept assessment and knowledge of lactation physiology. Not all nurses receive formal education on human milk and lactation. This resource can be used by primary care nurses to prioritize establishing and protecting the milk supply among families with a desire to breastfeed.

Background: The United States lacks a comprehensive framework to describe how multidisciplinary efforts to support breastfeeding and lactation fit together. The purpose of this article is to assess the roles of perinatal health care professionals in providing breastfeeding and lactation support (BFLS) along the perinatal care continuum and to offer a preliminary conceptual framework.

Study design: We conducted a scoping review to examine the breadth and depth of published position statements by perinatal care professional organizations about BFLS.

Methods: Methodology for scoping reviews outlined by Peters et al. (2020) was used. We identified nine professions as primarily implicated in provision of perinatal care in the United States, seven of which had national professional organizations. We searched PubMed and a generic web engine to identify position statements from those organizations. We used thematic analysis to create an adapted framework of the perinatal care continuum illustrating how BFLS from perinatal health care professionals can be mapped onto the care continuum.

Results: Some overlap in roles were noted as were some gaps regarding professional roles in different phases of the perinatal care continuum. Overall, most professional perinatal care organizations described specific BFLS roles for their practitioners and recommended collaboration with other perinatal care professions.

Clinical implications: The full spectrum of BFLS involves information sharing and anticipatory guidance which begins in the preconception period and lasts through 2 or more years postpartum. Interprofessional collaboration, such as through engagement with state-based perinatal quality collaboratives or other interprofessional perinatal partnerships, is essential to ensuring that families receive cohesive, comprehensive BFLS.

Purpose: As valuable members of the care team, medical assistants are well-positioned to assist breastfeeding families. The purpose of this study was to identify ways in which medical assistants in the pediatric primary care setting may be empowered to improve care and support for breastfeeding families.

Study design: A cross-sectional mixed-methods study was conducted using a one-time REDCap® survey including three open-ended prompts administered to medical assistants employed in primary care sites at Children's Hospital of Philadelphia from August 2022 through May 2023.

Methods: Descriptive statistics were used to summarize the background, training, and experience of respondents. Qualitative content analysis was used to identify themes in open-ended responses.

Results: Among the 78 medical assistants employed within Children's Hospital of Philadelphia's primary care network sites at the time of this study, 58 responded to the survey resulting in a response rate of 74%. Twenty-one locations were represented from Children's Hospital of Philadelphia's 31 pediatric primary care sites. Most medical assistants surveyed were providing informal breastfeeding support in the pediatric primary care setting and many were interested in learning more about breastfeeding and willing to offer more breastfeeding support to families.

Clinical implications: Medical assistants are a valuable part of the primary care team and have the potential to partner with nurses to make important contributions to the care and support of breastfeeding families.