Document Type
DNP Project
Publication Date
4-2025
Degree Name
Doctor of Nursing Practice
Faculty Advisor
Dr. Dorothea Esposito PhD(c), DNP MSN/ed, APRN, FNP-BC
Practice Mentor
Cassandra E. Haplin, RN, MSN
Abstract
Significance and Background: Prematurity related complications (PRC) are the second leading cause of death for children under the age of five. Breast milk (BM) contains bio-actives that reduce PRC. However, delayed BM expression (BME) reduces BM availability. Adherence to Baby Friendly Hospital Initiative’s recommendation for BME within 6 hours in mothers of neonatal intensive care unit (NICU) infants remain poor without a standardized BME protocol.
Purpose: To increase the percentage of NICU mothers initiating BME within 6 hours of birth. To educate labor and delivery nursing staff on early BME.
Methods: The Institute for Healthcare Improvement’s Model for Improvement Plan-Do-Study-Act (PDSA) framework was used to guide implementation in a Birthing Center of Connecticut. Participants include nursing staff and NICU mothers. Launch date was October 10th, 2024, with conclusion of data collection on January 20th, 2025. Three PDSA cycles were completed at this time. Data was collected using monthly chart audits and reviewed time and date of BME initiation, BME charting compliance and number of patients given BME education. Results: The percentage of NICU mothers initiating BME within 6 hours increased from 38.89% to 71.43%. Charting compliance decreased from 85% to 59% during the transition of the new charting system and increased to 77% by the conclusion of the project. The percentage of patients receiving BME education in the first 24 hours increased from 85% to 100% by the conclusion of the data collection period.
Discussion: The use of a standardized BME education protocol led to an increase in the percentage of NICU mothers pumping within 6 hours, increased the number of patients receiving BME education within 24 hours, and surpassed target goals. Results indicated that staff adopted the new practice protocol and educated patients consistently once the BME education protocol was implemented. Early BME has the high potential for increasing the availability of MM, directly impacting the incidence of prematurity-related complications among pre-term infants and the economic burden placed on families during prolonged NICU stays. Next steps for future implementation are to improve the time to initial oral administration of colostrum to NICU infants.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.
Recommended Citation
Balarezo, B. (2025). Implementing breast milk expression education protocol: A quality improvement project [Unpublished DNP project]. Sacred Heart University. https://digitalcommons.sacredheart.edu/dnp_projects/91
Comments
A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.