Ravneet Kaur1, Shashi Kant2, Akhil Dhanesh Goel3, Harsimar Bhatia4, Levis Murry5. 1. Associate Professor (Community Medicine), AIIMS, New Delhi, India. 2. Professor and Head (Community Medicine), AIIMS, New Delhi, India. 3. Assistant Professor (Family Medicine & Community Medicine), AIIMS, Jodhpur, India. 4. Postdoctoral Research Fellow, Johns Hopkins School of Medicine, Baltimore, USA. 5. Associate Professor, College of Nursing, AIIMS, New Delhi, India.
Abstract
BACKGROUND: Early initiation of breastfeeding (EIBF) has been shown to be associated with reduced neonatal mortality, but many barriers exist that lead to the delay of EIBF. We aimed at improving EIBF among newborns delivered at a secondary care hospital using standard quality improvement methods of root-cause analysis and the Plan-Do-Study-Act (PDSA) cycle. METHODS: The study was conducted in the year 2016-17 at a 50-bedded secondary care hospital in northern India. A baseline assessment of the timing of breastfeeding initiation was done, and factors contributing to delayed initiation of breastfeeding were analysed. Interventions were planned and implemented in short sequential PDSA cycles. The rapid-cycle aspect of PDSA began with piloting a new process, followed by examining results and responding by problem-solving, after which the next PDSA cycle was initiated. The percentage of newborns receiving breastfeeding within 1 h of birth was assessed on a monthly basis. RESULTS: The rate of early initiation of breastfeeding improved from 52% at baseline to 97% in the immediate post-training phase. After an initial fall due to the shortage of staff, the EIBF rate was sustained at 91% after six months. CONCLUSION: EIBF can be achieved through the involvement of all stakeholders, team-building, and commitment from managerial staff using the QI (Quality Improvement) approach.
BACKGROUND: Early initiation of breastfeeding (EIBF) has been shown to be associated with reduced neonatal mortality, but many barriers exist that lead to the delay of EIBF. We aimed at improving EIBF among newborns delivered at a secondary care hospital using standard quality improvement methods of root-cause analysis and the Plan-Do-Study-Act (PDSA) cycle. METHODS: The study was conducted in the year 2016-17 at a 50-bedded secondary care hospital in northern India. A baseline assessment of the timing of breastfeeding initiation was done, and factors contributing to delayed initiation of breastfeeding were analysed. Interventions were planned and implemented in short sequential PDSA cycles. The rapid-cycle aspect of PDSA began with piloting a new process, followed by examining results and responding by problem-solving, after which the next PDSA cycle was initiated. The percentage of newborns receiving breastfeeding within 1 h of birth was assessed on a monthly basis. RESULTS: The rate of early initiation of breastfeeding improved from 52% at baseline to 97% in the immediate post-training phase. After an initial fall due to the shortage of staff, the EIBF rate was sustained at 91% after six months. CONCLUSION: EIBF can be achieved through the involvement of all stakeholders, team-building, and commitment from managerial staff using the QI (Quality Improvement) approach.
Authors: J Clemens; R A Elyazeed; M Rao; S Savarino; B Z Morsy; Y Kim; T Wierzba; A Naficy; Y J Lee Journal: Pediatrics Date: 1999-07 Impact factor: 7.124
Authors: Joseph de Graft-Johnson; Linda Vesel; Heather E Rosen; Barbara Rawlins; Stella Abwao; Goldy Mazia; Robert Bozsa; Winifrede Mwebesa; Neena Khadka; Rosemary Kamunya; Ashebir Getachew; Gaudiosa Tibaijuka; Jean Pierre Rakotovao; Alemnesh Tekleberhan Journal: BMJ Open Date: 2017-03-27 Impact factor: 2.692