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Show Can Telehealth Lactation Services Provide Effective Breastfeeding Support for Rural Areas? Sadie Dahlsrud, RN, BSN, C-EFM, DNP Student; Project Chair: Janice Morse, RN, PhD, FAAN Key Findings: With staff support, telehealth lactation services raised average exclusive breastfeeding rates at discharge from 45.4% to 70.8% Background Breastfeeding rates nationwide are lower in rural than in urban areas; 56% vs. 71%. Project Site Exclusive Breastfeeding Rates February 2017-February 2018 Project Implementation In this rural central Utah hospital, baseline exclusive breastfeeding rate on hospital discharge was 45.4%. Nurse Experience (n=7) • Only 12% “strongly agree” they have time to assist with consults. Methods • Only 17% “strongly agree” that a bedside nurse is necessary during consults. • Nursing staff training session with pre and post-tests. • Nurses provided hands-on assistance with 29% of consults. • On-site promotion, implementation, and evaluation of telehealth lactation services for 25 patient, nurse, and IBCLC triads were conducted. Post-intervention surveys used a Likert scale of 1-5 where 1 was “strongly disagree” and 5 was “strongly agree.” Descriptive and parametric statistics measured mean differences. Lactation Consultant Experience (n=2) • Technology is adequate according to 90% of consultant responses. • Comparable to in-person consults: 87% “agree” or “strongly agree” telehealth is comparable in quality. • Measurement of breastfeeding to evaluate project impact. • Improved perception of telehealth (M= 3.6, SD= 1.2) vs. (M= 4.1, SD= 0.6; t(39)= -2.678, p= 0.01. • Increased average exclusive breastfeeding rates at discharge from 45.4% to 70.8%. • Continuation: 100% “agree” or “strongly agree” the consult encouraged breastfeeding continuation. Prior to project implementation, access to lactation consultants (IBCLC) in this rural central Utah hospital was not available. • Increased breastfeeding knowledge (M= 3.4, SD= 0.9) vs. (M= 3.8, SD= 0.6) t(39)= -2.199, p= 0.03. Patient Experience (n=25) • Increased mean confidence with breastfeeding (M= 3.8, SD= 0.9) vs. (M= 4.5, SD= 0.7) Z= -2.809, p= 0.004. Telehealth lactation services is an emerging resource that can provide rural areas with access to lactation consultants when not available for in-person consultations. Results: Nurse Training Session (n=41) Results: Telehealth Consults • Bedside nurse is essential: According to 95% of responses. Conclusions • Telehealth lactation consultations are feasible, can improve breastfeeding rates, and are acceptable to patients and consultants, however, nurses feel they lack the time to assist with consults. • Future projects might evaluate consult effectiveness when a bedside nurse is not available. COLLEGE OF NURSING |
