NSG 3150 – Healthcare Informatics
Week 6 – Peer Response Instructions
For the discussion response, please provide a substantive review of the presentations provided by two of your fellow students (
SEE THE TWO STUDENTS POWERPOINT ATTACHED). In your review, highlight the positive aspects as well as providing constructive criticism. Comments such as “Looks good!” or “I really liked your presentation” are unacceptable for a discussion peer review. Your classmates will appreciate any additional facts you can provide that are relevant and that will help to enrich their knowledge of the topic.
· Substantially respond to at least
two other student posts in a way that prompts further input or provides another viewpoint. Describe a situation from your nursing professional experience that backs up your viewpoint and discuss the social, moral, political, and economic factors impacting your position.
· Please respond to peers thoughtfully, add value to the discussion, and apply ideas, insights, or concepts from scholarly sources, such as: journal articles, assigned readings, textbook material, lectures, course materials, or authoritative websites.
· Provide a rationale for your response with at least one scholarly source using an APA in-text citation and full reference.
Technologies Used in Breastfeeding Protocols
Danyka Harrison RN
Galen College of Nursing
Nursing 3150- Healthcare Informatics
Mrs. Cammidge MSN, RN
Breastfeeding
Breastfeeding has been shown to be more beneficial compared to supplemental feedings done with formula. Trend tracking and monitoring of breastfeeding education, community response of birthing centers, and initiation are monitored due to medical contraindications to breastfeeding being rare.
“The American Academy of Pediatrics (AAP) recommends that birth hospitals or centers implement maternity care practices shown to improve breastfeeding initiation, duration, and exclusivity. The Centers for Disease Control and Prevention (CDC) and The Joint Commission monitor breastfeeding practices in US hospitals. Pediatricians play a critical role in hospitals, their practices, and communities as advocates of breastfeeding and, thus, need to be trained about the benefits of breastfeeding for mothers and children and in managing breastfeeding.” (Meek MD,MS,RD,FAAP, FABM, 2023)
The AAP recommends exclusive breastfeeding for approximately 6 months which concurs with World Health Organization, American College of Obstetricians and Gynecologists, American Academy of Family Physicians, and Canadian Pediatric Society. Utilizing a technology to trend and monitor breastfeeding exclusivity we can ensure and motivate more mothers to breastfeed longer as it is noted breastfeeding rates drop near the 3 month mark.
Evidence-Based Practice
UNICEF has created a Baby-Friendly Hospital Initiative that promotes and supports breastfeeding for all infants.
Main risks with introducing supplemental feedings early is poor breastfeeding habits, poor glucose control resulting in hypoglycemia which is important as newborns adjust to their postnatal environment, and low weight.
Mothers should be educated when requesting supplemental formula that “Breast is Best” as long as it is not contraindicated. Hospitals with this initiative are able to provide a variety of resources so the mother can make the best informed decision regarding breastfeeding.
Having a lactation consultant to assist and guide with breastfeeding techniques has shown to increase to number of ”breast-only” fed infants.
“It is important that breastfeeding mothers are educated on skills and strategies that promote successful breastfeeding and are offered support to help facilitate successful breastfeeding.”(Geneva: World Health Organization; 2018.)
Technologies in Protocol
Studies of infants from birth to the age of 6 months that exclusively breastfed had decreased rates of lower respiratory tract infections, severe diarrhea, otitis media, and obesity. By keeping up with accurate documentation of clinician visits and eating habits it is able to be documented breastfeeding reduces the amount of infant infection and hospitalizations.
Using trends to track growth rate, pediatrician sick visits, and if there has been any hospital admissions from kids who only were breastfed versus kids who received formula to supplement. Requiring that nursing staff weigh diapers to measure output and record daily weights on the patient as well as assessing how much the infant is feeding whether it be bottle or breast is all data that can be computed to assist the care team.
This data could help push the initiative of mothers of newborns choosing to breastfeed versus bottle feed as it seems like the healthier choice. Providing them with ample amount of research and documentation can help them make an informed decision.
By clinicians using EHR for real time documentation the benefits to breastfeeding can provide real time trends to display for data correlation and future studies regarding out of hospital visits and hospital admissions.
Communication
As I stated most baby-friendly facilities have a lactation consultant. Using EHRs to document the delivery of a newborn(s) assists the lactation consultant in being readily available to provide breastfeeding education. By using real time documentation staff can provide the appropriate resources to the new mother regarding her the infant(s). This documentation could include any dietary modification, calorie needs, birth deformities, as well as weight to assess growth and dietary needs. All this can be documented and recorded in real time to help staff provide the appropriate care and resources to make an informed decision regarding breastfeeding.
Not only is this a great help to mothers. They are there first hand to identify and problems the infant may have with feeding. If further medical evaluation is needed they are able to bring the problem to the forefront. The sooner a problem is addressed the sooner an infant can feed and live a proper healthy life.
Using EHRs lactation consultants, providers, and nurses are able to communicate any specific treatment needed prior, during, or after feedings. Identify any feeding abnormality and translate how to properly feed in cases of cleft lip, or cleft palate. Nurses record the infants’ output to ensure they are eating an appropriate amount as well. Real time documentation of eating habits can be recorded as well in the case that supplemental feeding is needed.
Nurse Access
Most large and Baby-Friendly facilities use Electronic Health Records or EHRs. Utilizing these systems providers are able to communicate diet orders and restrictions as well as assess intake and output as recorded by bedside nurses. Recording outputs help assist other clinicians and the lactation consultant if the infant is meeting their needed dietary or caloric intake. If assistance or education is needed it can be readily provided before the issue becomes catastrophic.
Primarily with infants blood glucose needs close monitoring as it can vary while the infant adapts to their new environment outside of the womb. Breastfeeding has been proven to be the best for glucose regulation in newborns within the first 72 hours. Monitoring and entering these numbers into the EHR can also help assist clinicians with diagnosing or identifying any feeding problems or abnormalities.
Lactation consultants are also able to use the system to review and assist any new updates as well patients request for assistance. They can document thorough notes that may assist the nursing staff during future feedings.
Noted Gaps
There is a great source of education and personnel in-house once you deliver but limited resources in the actual community regarding breastfeeding.
Education for breastfeeding should start early so the importance of the immunity and health properties are known beforehand. As clinicians our patient teaching for discharge starts upon admission. We should push for the healthiest option when it comes to our newborns and infants in the community.
This should include having resources readily available to mothers who may be struggling outside of a hospital setting with breastfeeding.
I currently reside in Harris County and I was most impressed that our WIC community actually has information and help regarding breastfeeding. The link is:
https://publichealth.harriscountytx.gov/Services-Programs/Services/Breastfeeding-Resources
Summary of Analysis
Breastfeeding has been proven to be the best option for infants from newborns to 6 months of age. But as long as 18 months if able.
Starting from community outreach trends and tracking from using technology to identify underserved communities and promote breastfeeding to working inpatient to track births and deliveries or communicate feeding restrictions or special needs to other staff members. Technology and breastfeeding are going hand in hand.
Patient teaching and utilizing EHRs to identify intake and output records as well as monitor blood glucose levels can assist staff members in early identification of GI/GU problems that may need to be addressed further.
Forming a team to provide outpatient community resources and education as well as follow up with breastfeeding habits upon discharge can help increase the effort of breastfeeding up to or past the age of 6 months.
Feedback Process
UNICEF and WHO have implemented a Baby-Friendly Hospital Initiative which covers the promotion of breastfeeding in a pamphlet translated into over 25 different languages.
“It is estimated that over 820,000 deaths among children under age 5 could be prevented worldwide every year if all children were adequately breastfed.”
With The Joint Commission also pushing the importance of breastfeeding more hospitals should join the initiative to give infants the optimal complete and healthy life.
Utilizing a team or task force to provide follow-up discharge and record infant feeding and intake/output trends can assist in ensuring infants are breastfed up to 6 months.
Providing patient teaching on keeping up and appointment management. Setting up and assisting patients with arriving to appointments.
Educating mothers on how to record accurate feeding data and outputs to assist in trend tracking.
EVDprotocolpowerpointfinalcopy.pdf
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