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J Obstet Gynecol Neonatal Nurs. 2014 Sep-Oct;43(5):614-24. doi: 10.1111/1552-6909.12479. Epub 2014 Aug 20.

Barriers and facilitators to implementing the Baby-Friendly hospital initiative in neonatal intensive care units.

Abstract

OBJECTIVE:

To explore manager, educator, and clinical leader perceptions of barriers and facilitators to implementing Baby-Friendly practice in the neonatal intensive care unit (NICU).

DESIGN:

Qualitative, descriptive design.

SETTING:

Two university-affiliated level-III NICUs in Canada.

PARTICIPANTS:

A purposive sample of 10 medical and nursing managers, nurse educators, lactation consultants, and neonatal nurse practitioners.

METHODS:

In-depth, semistructured interviews transcribed and analyzed using qualitative content analysis.

RESULTS:

Participants valued breastfeeding and family-centered care yet identified numerous contextual barriers to Baby-Friendly care including infant health status, parent/infant separation, staff workloads and work patterns, gaps in staff knowledge and skills, and lack of continuity of breastfeeding support. Facilitators included breastfeeding education, breastfeeding champions, and interprofessional collaboration.

CONCLUSION:

Despite identifying numerous barriers, participants recognized the potential value of expanding the Baby-Friendly Hospital Initiative (BFHI) to the NICU setting. Recommendations include promoting BFHI as a facilitator of family-centered care, interdisciplinary staff education, increasing access to lactation consultants, and establishing a group of NICU champions dedicated to BFHI implementation.

KEYWORDS:

BFHI; Baby-Friendly Hospital Initiative; NICU; barriers; breastfeeding; facilitators; implementation; neonatal intensive care unit

PMID:
25143255
DOI:
10.1111/1552-6909.12479
[Indexed for MEDLINE]

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