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临床整合型母乳喂养同伴咨询师方案的实施。

Implementation of a clinically integrated breastfeeding peer counselor program.

机构信息

Department of Obstetrics and Gynecology, NorthShore University HealthSystem; University of Chicago Pritzker School of Medicine, Evanston, IL, USA.

NorthShore Community Health Center, NorthShore University HealthSystem, Evanston, IL, USA.

出版信息

J Perinatol. 2024 Nov;44(11):1584-1590. doi: 10.1038/s41372-024-01995-3. Epub 2024 May 15.

Abstract

OBJECTIVE

Reflecting disparities across the US, in 2015 publicly insured patients of the NorthShore Community Health Center (NSCHC) in Evanston, Illinois had lower breastfeeding rates than commercially insured patients. We used the Replicating Effective Programs framework to describe the design and implementation of a clinically-integrated breastfeeding peer counseling (ci-BPC) program to address these disparities.

STUDY DESIGN

Patient focus groups and surveys informed program design, and a multidisciplinary clinical support team developed workflows that integrated the breastfeeding peer counselor (BPC) into the clinic and the postpartum unit.

RESULTS

ci-BPC improved breastfeeding intensity and duration by providing every NSCHC patient with (1) prenatal lactation education; (2) hands on lactation care in the hospital; and (3) on-demand postpartum support. Total cost per patient was $297-386. The program was sustained after demonstrating potential cost-savings.

CONCLUSION

An evidence-based, multidisciplinary collaboration resulted in a sustainable clinically integrated breastfeeding peer counseling program that improved breastfeeding outcomes.

摘要

目的

反映美国各地的差异,2015 年,伊利诺伊州埃文斯顿的北岸社区卫生中心(NorthShore Community Health Center,NSCHC)的公共保险患者的母乳喂养率低于商业保险患者。我们使用复制有效计划框架来描述临床整合母乳喂养同伴咨询(ci-BPC)计划的设计和实施,以解决这些差异。

研究设计

患者焦点小组和调查为项目设计提供了信息,一个多学科临床支持团队制定了将母乳喂养同伴咨询师(BPC)整合到诊所和产后病房的工作流程。

结果

ci-BPC 通过为每位 NSCHC 患者提供以下服务来提高母乳喂养的强度和持续时间:(1)产前哺乳教育;(2)在医院进行的实际哺乳护理;(3)按需产后支持。每位患者的总成本为 297-386 美元。该计划在证明有节省成本的潜力后得以维持。

结论

一项基于证据的多学科合作产生了一个可持续的临床整合母乳喂养同伴咨询计划,改善了母乳喂养结果。

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