(1099) Evaluation of a Breastfeeding Support Training Program for Nurses in the PICU

Introduction: The need for infants in neonatal and pediatric intensive care units (NICU/PICU) to receive breastmilk is paramount as it prevents complications, diminishes morbidity and mortality and enhances recovery. Lack of specialized breastfeeding support, knowledge and skills among healthcare professionals contributes to reduced rates of exclusive breastfeeding. To counteract this, the Institute for the Advancement of Breastfeeding and Lactation Education (IABLE) has developed an evidence-based 5.5-hour NICU/PICU breastfeeding champion program. We hypothesized that PICU nurses who completed this breastfeeding champion program would have increased capabilities (e.g., knowledge, self-efficacy), opportunities (e.g., time, institutional support), and motivation to provide breastfeeding support when comparing pre/post-assessments. This study aimed to evaluate the effectiveness of this program utilizing the Capabilities-Opportunities-Motivations-Behavior (COM-B) implementation science theory.

Methods: PICU nurses (n=91) who work in a 19-bed PICU in a large teaching hospital were recruited to participate in this study which included completing the NICU/PICU breastfeeding course and two (pre/post) cross-sectional (84-item) surveys to assess differences in COM-B constructs across six case scenarios. Response variables were based on a 5-point Likert scale to assess COM-B constructs. Each case scenario also included a nominal variable to assess care responsibility and the perceived importance of engagement. The analysis included descriptive statistics and parametric testing.

Results: Of the 32 nurses who completed the training, 26 (81.1%) finished both surveys that were paired and analyzed. Capability (p < 0.01) and responsibility (p < 0.05) in providing breastfeeding support were higher post-training, except for the management of positioning and latch for infants with/without tubes. There was a positive shift in opportunities to provide breastfeeding support and motivation remained high in both pre and post training, so no change was detected (p=1).

Conclusions: The NICU/PICU training led to improvements in nurses’ capability, opportunity, and responsibility to provide breastfeeding support. Future research should explore barriers and facilitators to implementing the knowledge gained in the NICU/PICU setting.