Essential II for the DNP states that “The DNP scope is distinguished by proficiency in conceptualizing new care models related to direct care, various populations and communities of care” (Anderson, 2015). The DNP leader needs to be able to target an at need population and implement a program or change to better serve them.
An example of such a program is “High 5 for Mom & Baby” funded by the United Methodist Health Ministry Fund to promote what is called a baby friendly hospital model. This program is to promote evidence based clinical education and practice in the rural hospital setting. The program promotes exclusive breastfeeding (UMHMF, n.d.). The American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months. 77% of mothers are initiating breastfeeding but only 16% are achieving the 6-month goal (Hawkins, 2015).
The High 5 program promotes the following 5 practices in Kansas Hospitals.
- At birth immediate skin to skin contact between the mother and baby after birth.
- Do not give newborns food or drink other than breast milk unless medically indicated.
- Practice “rooming in” allow mother and infants to remain together 24 hours a day.
- Give no pacifiers or artificial nipples to breastfeeding infants.
- Provide mothers breastfeeding support in the community.
Program implementation begins with a variety of healthcare providers such as the OB supervisors, labor and delivery nurses, medical staff and prenatal care providers. Policy and procedures are developed to follow the 5 recommendations. Order sets within the EMR are built to compliment the program recommendations. Once the policy, procedures and EMR templates are built education begins. Education reviews the EBR on exclusive breastfeeding and program guidelines. Once all these steps in preparation are taken the program is ready to be implemented.
The High 5 programs are designed to work in conjunction with community breastfeeding coalitions to support exclusive breastfeeding. This example shows a clinical practice that targets a specific population prior to birth with education, be implemented after the birthing experience and extends beyond to community support.
The link provided is an overview of a baby friendly hospital program: https://youtu.be/QwfY1VRCZcA
Anderson, A., Knestrick, J., Barroso, R. (2015). DNP Capstone Projects. Exemplars of Excellence in Practice. New York, NY. Springer
Hawkins, S. S., Stern, A. D., Baum, C. F., & Gillman, M. W. (2015). Evaluating the impact of the Baby-Friendly Hospital Initiative on breast-feeding rates: a multi-state analysis. Public Health Nutrition; Cambridge, 18(2), 189–197. http://dx.doi.org.ezproxy.fhsu.edu:2048/10.1017/S1368980014000238
Lawrence Memorial Hospital. (n.d.). High 5 for Mom & Baby. Retrieved from https://www.youtube.com/watch?v=QwfY1VRCZcA
Pérez-Escamilla, R. (2007). Evidence Based Breast-Feeding Promotion: The Baby-Friendly Hospital Initiative. The Journal of Nutrition, 137(2), 484–487. https://doi.org/10.1093/jn/137.2.484
UMHMF – High 5 for Mom and Baby. (n.d.). Retrieved June 14, 2018, from http://www.high5kansas.org/index.html