Implementation of an education package on breastengorgement aimed at lactation consultants andmidwives to prevent conflicting information forpostnatal mothers

摘要

Aim: The aim of this evidence-based practice project was to improve local practice in the treatment of breastengorgement in postnatal mothers and to ensure the treatment of engorgement in postnatal mothers is performedaccording to the best available evidence. Methods: This evidence-based practice project took place in a 28-bed postnatal ward in a large metropolitantertiary hospital. Twenty midwives and 20 in-patients were recruited for the project. The project utilized an audit andfeedback design. Midwives were asked a series of questions to test their knowledge on engorgement, and motherswere asked questions relating to the breastfeeding and engorgement care they received. The project was conductedin three phases: preparation for quality audit, implementation of best practice and postimplementation audit. Results: Comparison of Audit 1 (preimplementation) and Audit 2 (postimplementation) results shows significantimprovements in all eight audit criteria. An increase of 80% was achieved for the criteria 'midwives received formaleducation on engorgement' on completion of the project. A 20% increase in 'consistency of education regardinglatch' was reported by the mothers, and there was a 30% increase in 'information given to mothers on prevention andsigns of engorgement'. Sixty-five percent of midwives were able to correctly identify and manage engorgement, asignificant improvement from 5% at baseline. Conclusion: This evidence-based practice project successfully identified and utilized best practice in the manage-ment of breast engorgement care in mothers in our clinical setting. With effective breast engorgement interventionsin place, mothers could continue to successfully breastfeed their babies. The major challenges identified during theconduct of the project included: time constraints on the midwives to attend education sessions and to educatemothers on prevention. At the completion of this project, a closer relationship was forged between the lactationconsultant team and the midwives in the project setting. This increased the satisfaction and productivity of themidwives, and motivated them to deliver high-quality care, which contributed to an improvement in mother'sconfidence and reduction in conflicting information.