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CAPE FEAR VALLEY NICU PQCNC STORY

Early Contact = Early Milk

PQCNC at the Valley

Dont cry because its over, Smile because it happened.


Dr. Seuss

Rainy Day PQCNC


Data collection largely a failure for our unit Many contributing factors, but top two

RC

factor Accountability

Smiles for Our Successes


Slowly winning over some staff Seeing more S2S More babies receiving first feeding of human milk PQCNC network source of info and inspiration

We know we are better than this

We Begin
Success will be at the bedside Back to basics Tool already in place to help The Orange Contact Sheet

Developed

as reminder during admission 4 hour goal to visit mom Sheet turned to monitor Initially embraced, found to have 30-40% compliance

Summary of January Admissions Early Contact Sheet Completions (49 Admissions)

Not Completed-No Reason

24%

Not Completed-Maternal Complications Not Completed-Transfer In/Out Not Completed-Infant Expired Completed

4% 60% 10%

2%

aim
Increase the number of low-birth weight infants receiving breast milk by 50% Where to start?

Need

to have milk first Ensure moms are contacted early to begin pumping

How will we measure?


Contact

sheets monitored Report progress to staff

setting
CFV NICU 44 bed Unit 600 admissions per year 75-80 RNs

Nurse

driven initiative Role of LC group work in progress

mechanisms
Need to contact all moms Main focus <1500 grams Returning to our roots Early contact sheets already in use Easy to monitor Results gathered quickly Results easy to plot on run chart

methods
Make Early Contact part of the admission Secretaries will include bright orange sheet in admission paperwork Parent folder developed by Breastfeeding Committee Staff education, inservice as well as ~

Bulletin

boards Stall walls Newsletter

methods

measures
Orange Contact Sheets Initially reviewed at months end Decided turn around time too long Began to monitor cohorts of 10 Data reported on run charts Use rates climb, 80-100% Now monitored in groups of 20 admissions

results (150 admissions)


Last Quarter's Summary of Early Contact Sheet Completion (150 Admissions)
Not Completed- Lack in understanding importance of early contact Not Completed-Maternal Complications

23% 2% 71% 4% 0%

Not Completed-Transfer In/Out

Not Completed-Infant Expired

Completed

results (150 admissions)


Moms Contacted Within 4 Hours
100 90 80 Percentages 70 60 50 40 30 20 10 0 1 3 5 7 9 11 13 15
Moms contacted in 4 hours

Sets of 20 Admissions

results (150 admissions)


Infants That Received First Breastmilk Feed in 6 Hours
100 90 Percentages 80 70 60 50 40 30 20 10 0 1 3 5 7 9 11 13 15
infants that received first breastmilk feed in 6 hours

Sets of 20 Admissions

results (150 admissions)


Infants Receiving Breastmilk Within 24 Hours
100 90 80 70 60 50 40 30 20 10 0 Percentages

Infants receiving breastmilk within 24 hours

Sets of 20 Admissions

results (150 admissions)


Early Contact Equals Higher Chance at Receiving Breastmilk as First Feed
100 90 80 70 60 50 40 30 20 10 0 Early Contact Made and Received Breastmilk First Early Contact Not Made and Received Breastmilk First Percentages Based on Past Quarter (150 Admissions) 69 Admissions Early Contact Made vs. 81 Admissions Early Contact Not Made

results (150 admissions)


How Maternal Contact Affects First Feed
100 90 80 70 Percentages 60 50 40 30 20 10 0 Contact Made and Recived Breastmilk as First Feed Contact not made and received Breastmilk as First Feed Axis Title Data of <1500 Gram Babies from Previous Quarter (October-December 31 Admissons)

discussion
Babies need milk = simple Getting milk = complicated We expected to be further LC can be effective LDR LC successful LDR RN = early milk

Its not about what it is, its about what it can become.
Dr. Seuss, The Lorax

Excellence in Care
We are committed to providing excellence Lorax theme will be used Focus will center on each individuals commitment to quality

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