Assessing the knowledge and confidence to perform breastfeeding practices in the neonatal unit – A case study of the use of the Neonatal Unit Clinician Assessment Tool (NUCAT) in Coventry, England

Wallace, Louise; Higman, Wendy; Blake, Kathryn; Law, Susan; Anwar, Kubra

doi:10.1016/j.jnn.2013.01.001

Cited by 5 publications

(5 citation statements)

References 17 publications

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“…The study indicates the new DVD training method is effective in improving professionals’ knowledge in each area of P & A, HE. Improvements in mean knowledge scores were not moderated by age, time working with breastfeeding mothers, job type, years since qualification, seniority (job title) and prior to breastfeeding training experience.This finding is similar to a study which assessed breastfeeding knowledge among 51 clinicians in a neonatal unit in England using a similar multiple choice test of knowledge, where personal and job variables similar to those in this study were not associated with differences in objectively assessed knowledge [ 36 ].…”

Section: Discussionsupporting

confidence: 88%

A randomised controlled trial of the effectiveness of a breastfeeding training DVD on improving breastfeeding knowledge and confidence among healthcare professionals in China

Yuan

Wallace

et al. 2018

BMC Pregnancy Childbirth

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BackgroundDespite almost all babies being breastfed initially, the exclusive breastfeeding rate at six months is less than 30% in China. Improving professionals’ knowledge and practical skill is a key government strategy to increase breastfeeding rates. This study aimed to test the effectiveness of a breastfeeding DVD training method for clinicians on improving their knowledge and confidence in the breastfeeding support skills of teaching mothers Positioning and Attachment (P & A) and Hand Expression (HE).MethodsA randomised controlled trial was conducted in three hospitals in Zhejiang province, China in 2014. Participants were recruited before their routine breastfeeding training course and randomly allocated to intervention group (IG) and control group (CG). The 15 min “Breastfeeding: Essential Support Skills DVD” was the intervention for IG and a vaginal delivery DVD was used for CG. All participants completed questionnaires of job information, knowledge and confidence in the two skills before (baseline) and immediately after viewing the DVD (post DVD).ResultsOut of 210 participants, 191 completed knowledge assessments before and after watching the DVD (IG n = 96, CG n = 95), with the response rate of 91.0%. At baseline, there are no significant differences in job variables, total knowledge scores and confident scores. The total knowledge score significantly increased post-DVD for IG (pre-DVD: M = 5.39, SD = 2.03; post-DVD: M = 7.74, SD = 1.71; t (95) = − 10.95, p < 0.01), but no significant change in total knowledge score for CG between pre- and post-DVD (pre-DVD: M = 5.67, SD = 1.70; post-DVD: M = 5.56, SD = 1.63; t (94) = 0.85). The total confidence scores were significantly higher post-DVD than pre-DVD in IG (pre-DVD: M = 66.49, SD = 11.27; post- DVD: M = 71.81, SD = 9.33; t (68) = − 4.92, p < 0.01), but no significant difference was seen in CG between pre- and post-DVD total confidence scores (pre-DVD: M = 68.33, SD = 11.08; post-DVD: M = 68.35, SD = 11.40; t (65) = − 0.25). Personal and job variables did not mediate these effects.ConclusionsThe breastfeeding training DVD improved professionals’ knowledge and confidence of the two breastfeeding support skills. However, the effect on professionals’ practice and on breastfeeding outcomes needs to be examined in the future.

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Section: Discussionsupporting

confidence: 88%

A randomised controlled trial of the effectiveness of a breastfeeding training DVD on improving breastfeeding knowledge and confidence among healthcare professionals in China

Yuan

Wallace

et al. 2018

BMC Pregnancy Childbirth

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“…Admission to the NICU, and not the reason for admission or length of stay in the NICU, was associated with both decreased rates of exclusive breast feeding and the duration of any breast feeding. Lower breast feeding rates in the NICU compared to the postnatal wards in maternity hospitals has been previously reported (Wallace et al, 2013). Previous studies investigating breast feeding rates in NICU have primarily focused on a specific neonatal population (Bonet et al, 2010;Maia et al, 2011;Lee et al, 2012) and not on a population-based cohort.…”

Section: Discussionmentioning

confidence: 94%

Early life factors associated with the exclusivity and duration of breast feeding in an Irish birth cohort study

et al. 2015

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“…The only area in which the clinicians did not improve was their knowledge of the 'benefits of breastfeeding', however this may reflect a ceiling effect as clinicians reported high knowledge of the benefits of breastfeeding prior to the intervention. It is often the case that health professionals providing care to breastfeeding women and their infants can cite the benefits of breastfeeding (Radzyminski & Callister, 2015) and feel most confident in their knowledge about the benefits of breastfeeding (Wallace, Higman, Blake, Law & Anwar, 2013). However there remains a gap between their knowledge of the benefits and actual clinical practice in promoting breastfeeding (Radzyminski & Callister, 2015).…”

Section: Discussionmentioning

confidence: 99%

“…It is recognised that appropriately skilled clinicians within neonatal units have a key role to play in the provision of family centred care and more specifically in supporting parents to initiate and maintain breastfeeding and kangaroo care (Renfew et al, 2012). Recent studies have highlighted that nursing staff recognise that supporting breastfeeding is central to their role, and recognise breastfeeding as positive for both mother and baby (Myers & Rubarth, 2013;Wallace et al, 2013). However they report a poor understanding of the evidence base behind best practice and low confidence to support parents to breastfeed (Wallace et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies have highlighted that nursing staff recognise that supporting breastfeeding is central to their role, and recognise breastfeeding as positive for both mother and baby (Myers & Rubarth, 2013;Wallace et al, 2013). However they report a poor understanding of the evidence base behind best practice and low confidence to support parents to breastfeed (Wallace et al, 2013). Similarly, lack of evidence based staff education (Higman et al, 2015) and clear guidance (Seidman et al, 2015) have been reported as key barriers for clinicians to support kangaroo care.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of an intervention to increase clinician knowledge and confidence to support breastfeeding, kangaroo care and positive touch within neonatal units

Kwah

Whiteman

Grunfeld

et al. 2018

Journal of Neonatal Nursing

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2018) Evaluation of an intervention to increase clinician knowledge and confidence to support breastfeeding, kangaroo care and positive touch within neonatal units. AbstractBreastfeeding and kangaroo care rates in neonatal units across the United Kingdom vary despite evidence for the clinical benefits. Clinicians have reported a need for evidence-based training to support parents with these practices. The aim of this study was to evaluate the Small Wonders Change Programme (SWCP), an intervention that aims to increase clinician knowledge and confidence to support parents in neonatal units to undertake breastfeeding and kangaroo care. Two neonatal intensive care units participated and 47 clinicians completed the Neonatal Unit Assessment Tool (NUCAT) pre and post-intervention. 18 of these clinicians also participated in a semi-structured interview to further explore the impact of the intervention on clinician's practice. Both clinician knowledge (t(46)=4.61, p<=0.000) and confidence (pre t(46)=4.82, p<.000) significantly increased following the intervention. Analysis of the interviews revealed that clinicians directly attributed subsequent individual and unit-wide change in practice to an increase in knowledge and confidence as a result of the intervention. This study suggests that a clinician focussed intervention can lead to positive changes in clinician confidence, knowledge and practice in supporting parents to undertake breastfeeding and kangaroo care in neonatal units.

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Assessing the knowledge and confidence to perform breastfeeding practices in the neonatal unit – A case study of the use of the Neonatal Unit Clinician Assessment Tool (NUCAT) in Coventry, England

Cited by 5 publications

References 17 publications

A randomised controlled trial of the effectiveness of a breastfeeding training DVD on improving breastfeeding knowledge and confidence among healthcare professionals in China

A randomised controlled trial of the effectiveness of a breastfeeding training DVD on improving breastfeeding knowledge and confidence among healthcare professionals in China

Early life factors associated with the exclusivity and duration of breast feeding in an Irish birth cohort study

Evaluation of an intervention to increase clinician knowledge and confidence to support breastfeeding, kangaroo care and positive touch within neonatal units

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