PQCNC EHM NCCC LS3 Cape Fear Valley NICU Story

7/28/2019 PQCNC EHM NCCC LS3 Cape Fear Valley NICU Story...

http://slidepdf.com/reader/full/pqcnc-ehm-nccc-ls3-cape-fear-valley-nicu-story 1/22

CAPE FEAR VALLEYNICU PQCNC STORY

Early Contact = Early Milk



a e

Valley “Don’t cry

because it’s

over,

Smile because

it happened.”Dr.

Seuss



Rainy Day PQCNC

¨ Data collectionlargely a failure for

our unit¨ Many contributing

factors, but top two

¤ RC factor

¤ Accountability



m es or ur

Successes¨ Slowly winning over some staff

¨ Seeing more S2S¨ More babies receiving first feeding of

human milk

¨ PQCNC network source of info andinspiration



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)

24%

4%

10%

2%

60%

Not Completed-No Reason

Not Completed-Maternal Complications

Not Completed-Transfer In/Out

Not Completed-Infant Expired

Completed



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 beginpumping

¨ 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 month’s 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)

23%

2%

4%0%

71%

Last Quarter's Summary of Early Contact Sheet Completion (150

Admissions)

Not Completed- Lack in understanding

importance of early contact

Not Completed-Maternal Complications

Not Completed-Transfer In/Out

Not Completed-Infant Expired

Completed




010

20

30

40

50

60

70

80

90

100

1 3 5 7 9 11 13 15

P e r c e n t a g e s

Sets of 20 Admissions

Moms Contacted Within 4 Hours

Moms contacted in 4 hours




0

10

20

30

40

50

60

70

80

90

100

1 3 5 7 9 11 13 15



Infants That Received First Breastmilk Feed in 6 Hours

infants that received first breastmilk feedin 6 hours




0

10

20

30

40

5060

70

80

90

100

P e r c e

n t a g e s


Infants Receiving Breastmilk Within 24 Hours

Infants receiving breastmilk within 24hours




0

10

20

30

40

50

60

70

80

90

100

Early Contact Made and Received

Breastmilk First

Early Contact Not Made and Received

Breastmilk First

Early Contact Equals Higher Chance at ReceivingBreastmilk as First Feed

Percentages Based on Past Quarter (150

Admissions) 69 Admissions Early Contact

Made vs. 81 Admissions Early Contact Not

Made




0

10

20

30

40

50

60

70

80

90

100

Contact Made and Recived

Breastmilk as First Feed

Contact not made and received

Breastmilk as First Feed


Axis Title

How Maternal Contact Affects First Feed

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



“It’s not aboutwhat it is,

it’s about what it

can become.”Dr. Seuss, The Lorax



Excellence in Care¨ We are committed

to providing

excellence

¨ Lorax theme willbe used

¨ Focus will center

on each individualscommitment to

quality

Documents

PQCNC EHM NCCC LS3 Cape Fear Valley NICU Story