Authors (including presenting author) :
LEUNG YN (1)(3), YEUNG A KM(1)(3), CHAN LP (1)(3), TSE PS (1)(3), CHAN KM(2)(3), SO HY(2)(3), CHUNG SF (1)(3), LAM YY (2)(3), LEUNG WC(1)(3)
Affiliation :
(1)Department of Obstetrics and Gynecology, (2) Department of Pediatrics, (3) Kwong Wah Hospital
Introduction :
Early and effective breastfeeding supports with milk expression (within 6 hours after birth) are known to be crucial for the separated mother-baby dyads. Our hospital showed substantial gap in annual breastfeeding survey. In order to enhance the practice, an improvement project aiming at revamping the workflow for collection and transport of expressed breastmilk within 6 hours of birth from maternity wards to neonatal unit and strengthening milk expression skill of newly graduated midwives was implemented and commenced in January 2018.
Objectives :
To examine the effectiveness of and staff’s opinion on the streamlined workflow.
Methodology :
The revamped workflow was launched on 1st January 2018. Staffs including midwives, nurses and supporting staffs working in labour room, postnatal ward and neonatal unit (NNU) were involved in the improvement project. Numbers of first colostrum collected in maternity wards was recorded. The percentage of babies receiving colostrum (≤6 hours since birth) in NNU was examined. Opinion of staffs who have participated in workflow redesign was collected using a self-administered, structured questionnaire. The competency in hand expression and collection of colostrum for new graduate midwives in a postnatal ward was evaluated. The data were subjected to descriptive and univariate analysis.
Result & Outcome :
A total of 1242 newborn babies were directly admitted to NNU from delivery suite after birth in 2018. 301 babies who have received (≤ 6 hours after birth) colostrum in NNU were significantly increased by 22.2% (24.5% in 2018 versus 2.3% in 2017). The enhanced workflow was statistically associated with higher rate (OR 13.87, 95% CI 9.6-20.05, p< .001). 77% (n=23) staffs reported that the revamped workflow helped breastfeeding (mean 3.97±SD 0.67). 90% (n=28) staffs agreed that babies could receive colostrum earlier (mean 4.23±SD 0.63). 70 %( n=21) felt the necessity to change the workflow (mean 3.87± SD 0.68). The overall staff satisfaction rate was 70 %( mean 3.83±SD 0.65). 80% (n=4) new graduate midwives attained competency level of ≥3. Conclusions: More mothers were significantly helped and more babies could receive early colostrum through this program. By improving communication and interdepartmental collaboration through staff engagement and empowerment, it is possible to enhance and advance our care toward excellence. Furthermore, the result translates into satisfaction of all stakeholders.
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