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Vol. 30. Issue 3.
Pages 168-175 (May - June 2020)
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Vol. 30. Issue 3.
Pages 168-175 (May - June 2020)
Original article
DOI: 10.1016/j.enfcle.2020.03.002
Application and evaluation of the best practice guideline: Breastfeeding
Aplicación y evaluación de la Guía de buenas prácticas: lactancia materna
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Patricia Del Rio-Martíneza, Maribel López-Garcíaa,
Corresponding author
, Cristina Nieto-Martínezb, Mª Angeles Cabrera-Cabrerac, F. David Harillo-Acevedod, Aurora Mengibar-Carrilloe, María González-Gallegof, Mª Ángeles Maestre-Garcíag, Work group of the best practices implementation programme in centres committed to excellence of care Best Practices Spotlight Organisations BPSO
a Unidad de Tocoginecología, Hospital de Mendaro, OSI Debabarrena, Gipuzkoa, Spain
b Unidad de Ginecología y Obstetricia, Hospital Clínico San Carlos, Madrid, Spain
c Unidad Materno Infantil, Hospital Valle del Nalón, Asturias, Spain
d Unidad de Paritorio, Hospital Rafael Méndez, Lorca, Murcia, Spain
e Unidad de Pediatría, Hospital General Mancha Centro, Alcázar de San Juan, Ciudad Real, Spain
f Área de Pediatría, Centro de salud Ponferrada II, Ponferrada, Spain
g Unidad de Ginecología y Obstetricia, Hospital Doctor José Molina Orosa, Área de Salud de Lanzarote, Gerencia de Servicios Sanitarios, Arrecife, Lanzarote, Spain
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Table 1. Centres committed to excellence of care certified for BPSO breastfeeding guideline implementation.
Abstract
Objective

To analyse the progress of care in the promotion of breastfeeding and describe breastfeeding results following the implementation of the RNAO guideline in various types of national health centres.

Method

Quantitative descriptive longitudinal study of the results of implementing the recommendations of the RNAO-Breastfeeding guideline in 9 national health centres following the implementation methodology of the programme of the Best Practice Spotlight Organization®. Process and result variables are collected at hospital level and in primary care by registering on the CAREVID platform. The weighted mean was calculated as a summary statistic.

Results

The implementation of the recommendations of the Breastfeeding guideline was associated with a relative increase in: skin-to-skin contact 57.7% (p < 0.000), exclusive breastfeeding in the 1st intake 47.8% (p < 0.000), exclusive breastfeeding on hospital discharge 18.4% (p < 0.000) and prenatal education 63.95% (p < 0.00).

Conclusion

The implementation of the RNAO-Breastfeeding guideline in different national health centres has increased the application of the recommendations based on scientific evidence, generalising appropriate breastfeeding care (such as prenatal education, application of skin-to-skin contact and exclusive breastfeeding in the first intake) and is consequently significantly approaching the international recommendations on breastfeeding.

Keywords:
Practice guideline
Breast feeding
Prenatal education
Best Practice Spotlight Organization®
Resumen
Objetivo

Analizar la evolución de los cuidados para favorecer la lactancia materna (LM) y describir los resultados de la lactancia materna tras la implantación de la guía RNAO en diversos tipos de centros sanitarios nacionales.

Método

Estudio descriptivo cuantitativo longitudinal de los resultados de la aplicación de las recomendaciones de la guía RNAO-LM en 9 centros sanitarios nacionales siguiendo la metodología del programa Best Practice Spotlight Organization®. Se recogen variables de proceso y resultado en el ámbito hospitalario y en atención primaria mediante el registro en la plataforma CAREVID. Los resultados globales se expresan como media ponderada de los centros participantes.

Resultados

La implantación de las recomendaciones de la guía de LM se asoció a un incremento relativo de: contacto piel con piel 57,7% (p < 0,000), LM exclusiva (LME) en la 1ª toma 47,8% (p < 0,000), LME al alta hospitalaria 18,4% (p < 0,000) y educación prenatal 63,95% (p < 0,00).

Conclusión

La implantación de la guía RNAO-LM en diversos centros en el ámbito nacional ha incrementado la aplicación de las recomendaciones, consiguiendo generalizar los cuidados adecuados en LM (como educación prenatal, aplicación del contacto piel con piel y LME en la primera toma), aproximándose significativamente a las recomendaciones internacionales sobre LM.

Palabras clave:
Guía de práctica clínica
Lactancia materna
Educación prenatal
Centro Comprometido con la Excelencia en Cuidados®

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