Best Fed Beginnings: A Nationwide Quality Improvement Initiative to Increase Breastfeeding
Best Fed Beginnings: A Nationwide Quality Improvement Initiative to Increase Breastfeeding
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DOI：
10.1542/peds.2016-3121
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发表时间：
2017-07-01
期刊：
影响因子：
8
通讯作者：
Homer, Charles J.
中科院分区：
文献类型：
--
作者：
Feldman-Winter, Lori;Ustianov, Jennifer;Homer, Charles J.
背景与目的：针对美国爱婴指定医院数量少的问题，疾病控制和预防中心资助国家儿童健康质量研究所在2011年至2015年期间开展了一项全国质量改进倡议。该倡议被称为最佳喂养的开始，并在全国范围内的倡议，以增加母乳喂养，实现Baby-Friendlydesignation.METHODS：干预期从2012年7月至2014年8月。在此期间，收集了与成功母乳喂养十个步骤相一致的过程指标和成果措施（总体和专门与母乳喂养有关）的数据。此外，在干预结束后至2016年4月收集了关于婴儿友好型指定的数据。医院组建了多学科小组，其中包括家长伙伴和社区代表。三个人的学习课程穿插远程学习和变化的测试，和一个基于Web的平台容纳资源和数据广泛sharing.RESULTS：到2016年4月，共有72（80%）的90家医院收到了婴儿友好的指定，近一倍的指定医院在美国的数量。与未参加该计划的医院申请者相比，参加最佳美联储开始计划与指定有显著高相关性（Pearson's r [235]：0.80; P < .01）。总体母乳喂养率从79%上升到83%（t = 1.93; P = 0.057），纯母乳喂养率从39%上升到61%（t = 9.72; P <0.001）。这些变化伴随着纯母乳喂养的显著增加。
BACKGROUND AND OBJECTIVE: In response to a low number of Baby-Friendly designated hospitals in the United States, the Centers for Disease Control and Prevention funded the National Institute for Children's Health Quality to conduct a national quality improvement initiative between 2011 and 2015. The initiative was entitled Best Fed Beginnings and enrolled 90 hospitals in a nationwide initiative to increase breastfeeding and achieve Baby-Friendly designation.METHODS: The intervention period lasted from July 2012 to August 2014. During that period, data on process indicators aligned with the Ten Steps to Successful Breastfeeding and outcome measures (overall and exclusively related to breastfeeding) were collected. In addition, data on the Baby-Friendly designation were collected after the end of the intervention through April 2016. Hospitals assembled multidisciplinary teams that included parent partners and community representatives. Three in-person learning sessions were interspersed with remote learning and tests of change, and a Web-based platform housed resources and data for widespread sharing.RESULTS: By April 2016, a total of 72 (80%) of the 90 hospitals received the Baby-Friendly designation, nearly doubling the number of designated hospitals in the United States. Participation in the Best Fed Beginnings initiative had significantly high correlation with designation compared with hospital applicants not in the program (Pearson's r [235]: 0.80; P < .01). Overall breastfeeding increased from 79% to 83% (t = 1.93; P = .057), and exclusive breastfeeding increased from 39% to 61% (t = 9.72; P < .001).CONCLUSIONS: A nationwide initiative of maternity care hospitals accomplished rapid transformative changes to achieve Baby-Friendly designation. These changes were accompanied by a significant increase in exclusive breastfeeding.