Thursday, July 10, 2008

Vickie's Research Corner

Welcome to Vickie’s Research Corner. Summer is here and just like the weather our research is hot! I would like to introduce you to Mary Wright, manager of Labor and Delivery. She has a very wonderful ongoing study called “ Attitudes, Knowledge, and Beliefs of Perinatal Staff Related to Breastfeeding Success.”

What is your study about?
My study examines staff’s knowledge, attitudes, and beliefs of breastfeeding and how these factors impact breastfeeding success with patients.

Is it EBP/Research Study?
A quantitative research study; pretest/posttest design.

What made you interested in this project?
Our hospital was examining initiatives regarding becoming a Baby Friendly Hospital. According to the Baby Friendly Hospital Initiative (BFHI) (2006),”More than one million infants worldwide die every year because they are not breastfed or are given other foods too early. Millions more live in poor health, contract preventable diseases, and battle malnutrition.” In our culture we tend to enforce more formula feeding than breastfeeding and have an increased risk of diarrhea, respiratory and ear infections, and allergic skin disorders (BFHI, 2006). Baby-Friendly USA is the national authority for the BFHI in the United States.
BFHI stated, “In 1992, the Healthy Mothers, Healthy Babies Coalition received a grant from the US Department of Health and Human Services to convene an Expert Work Group to examine the criteria and assessment process of the global BFHI. Wellstart International, which is located in San Diego, California, developed the evaluation materials to support the assessment process. The U.S. Committee for UNICEF supported these efforts financially and with “in kind” services. In January of 1997, Healthy Children Project, Inc. accepted responsibility for the initiative and worked to form Baby-Friendly USA as the non-profit organization, which now implements the Baby-Friendly Hospital Initiative in the United States (2006).
BFHI uses ten steps to aid hospitals in the encouragement of breastfeeding. When I thought about implementing these changes to our staff, I decided I really needed to know current knowledge, beliefs, and attitudes of the staff to understand what we were doing well and what we weren’t and why.

How did you go about your research?
Well, I met Dana Rutledge a lot when I decided to do research on the staff. We began looking at previous studies. We designed a twenty one-item survey tool looking at things that have been done here at St. Josephs and what should be done. I then had to go through the St. Joseph IRB for approval. I also had to go through the IRB at California State Fullerton because this project also became a school project. I then surveyed the nurses, wrote a three chapter thesis, and then inputted the data in an excel file and Dana Rutledge and myself analyzed the data. I then presented my findings at the Sigma Theta Tau induction via a poster.

What are your expected outcomes?
Well I have done the pretest already and have data. Two hundred perinatal staff members were surveyed from the perinatal department. I was pleased with what the nurses did know, such as understanding breastfeeding (BF) should be encouraged and education of reasons why is important. I also found that 90% of the nurses knew that formula wasn’t nutritionally equal to milk. This sounds like a big number but in a perinatal staff this number should be 100%, we are striving for perfect care. I realized that I needed to customize the education to my nurses. We will be performing the post test in 2009 after the nurses have been educated.

Have you done research before? If so what did you learn?
No. I learned that I needed to take good notes when setting up a study as well as how to input data in excel, analyze, and actually understand the data you have collected and what that means to your practice. It is so nice to be able to put the numbers to what I actually knew about the nurses and have other people able to analyze the results.

Will you do research/project again?
YES! I have two projects in the works already. I think I’m crazy! In perinatal we are going to look at gum chewing in post-operative c-section patients. There is no data in the literature and this would be great to see if it decreased post-operative complications such as ileus as in colorectal patients. I am also working with one of the anesthesiologists from here to determine a better way to measure hydration with pulsoximeters more effectively in labor and delivery patients with epidurals.


Baby Friendly Hospital Initiaitive (2006). What is the Baby-Friendly Hospital Initiative and why do we need it? Retrieved 06-26-08, from

Baby Friendly Hospital Initiative (2006). The Ten Steps To Successful Breastfeeding. Retrieved 06-26-08, from