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Auteur Joan Esper Kuhnly
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Lactation Assessment Tools: A Qualitative Analysis of Registered Nurses’ Perceptions of Tool Limitations and Suggested Improvements / Donna J. Chapman in Journal of Human Lactation, Vol. 34, n°4 (Novembre 2018)
Titre : Lactation Assessment Tools: A Qualitative Analysis of Registered Nurses’ Perceptions of Tool Limitations and Suggested Improvements Type de document : texte imprimé Auteurs : Donna J. Chapman, Auteur ; Joan Esper Kuhnly, Auteur Année de publication : 2018 Article en page(s) : pp. 682–690 Langues : Anglais (eng) Catégories : Consultant en lactation
Etude de cas ou de cohorte
Résumé : "Background
Several lactation assessment tools are available for in-hospital assessment of breastfeeding dyads, and their components vary widely. To date, no research has evaluated the perceptions of registered nurses (RNs) regarding the limitations and future improvements of these tools.
The aim was to describe RNs’ perceptions of the limitations of currently used lactation assessment tools and how these tools could be enhanced.
Focus groups (n = 7) were conducted with RNs (N = 28) whose current responsibilities included in-hospital breastfeeding assessment. Recruitment occurred from April through July 2015 at regional and international lactation conferences. Focus groups were audiotaped and transcribed verbatim. Two lactation researchers analyzed the transcripts to identify emerging themes and subthemes.
RNs identified three key limitations of the tools included being too subjective and time-consuming, difficulty in assessing audible swallows, and missing the big picture (e.g., overemphasizing numbers, being a snapshot in time). Suggested improvements focused on maternal characteristics (evolving breasts and nipples, holding it together, “got milk?,” risk factors, embracing the role), infant characteristics (day of life, latch/suck/swallow, baby’s “driving the bus,” risk factors for supplemental feeding), their interaction (two to tango, positioning, better qualitative descriptors), and tool organization (formatting and multiple versions).
RNs suggested novel components for consideration when developing future lactation assessment scales, including removing audible swallowing, adding mother/infant interactions, infant output, and expressible colostrum, and developing criteria specific to infant age. Future research should translate these suggestions into evidence-based indicators and evaluate the resulting proposed tools for reliability and validity. [Résumé de l'auteur]
in Journal of Human Lactation > Vol. 34, n°4 (Novembre 2018) . - pp. 682–690[article]Qualitative Analysis of Registered Nurses’ Perceptions of Lactation Assessment Tools: Why and How They Are Completed / Joan Esper Kuhnly in Journal of Human Lactation, Vol. 34, n°1 (Février 2018)
Titre : Qualitative Analysis of Registered Nurses’ Perceptions of Lactation Assessment Tools: Why and How They Are Completed Type de document : texte imprimé Auteurs : Joan Esper Kuhnly, Auteur Année de publication : 2018 Article en page(s) : pp. 32-39 Langues : Anglais (eng) Catégories : Infirmière
Résumé : "Background:
Although lactation assessment tools are consistently used in clinical practice, there is no evidence describing registered nurses’ perspectives regarding the purpose and thought processes involved when conducting a breastfeeding assessment.
This study aimed to explore registered nurses’ perceptions on the purpose of lactation assessment tools and the thought processes involved in completing one.
Seven focus groups were held from April 2015 through July 2015, in coordination with regional and international lactation and perinatal conferences. Participants included 28 hospital-based registered nurses who routinely used a lactation assessment tool to assess postpartum mothers with healthy breastfeeding newborns. Focus groups were audiotaped, transcribed verbatim, and content analyzed by two lactation researchers to identify relevant themes and subthemes.
The analyses identified four different purposes of breastfeeding assessment tools (Teaching and Assessing Simultaneously, Infant Safety, Standardized Practice, and “It’s Your Job!”) and four themes related to the thought processes used in completing the tool (Novice vs. Expert, Real-Time vs. Recalled Documentation, Observation or Not, and “Fudging the Score”).
Registered nurses found lactation assessment tool completion to be an essential part of their job and that it ensured infant safety, standardized care, maternal instruction, and lactation assessment. Differences in the lactation assessment tool completion process were described, based on staff expertise, workload, hospital policies, and varying degrees of compliance with established protocols. These findings provide critical insight for the development of future breastfeeding assessment tools."[resume de l'auteur]
in Journal of Human Lactation > Vol. 34, n°1 (Février 2018) . - pp. 32-39[article]