Subject Matter Experts Identify Health Equity Concerns in Breastfeeding for African American Women.

Although the rate of breastfeeding initiation in the United States has continued to rise since 1972, African American mothers continue to experience a significant disparity in initiation. The aim of this study was to explore the perceptions of the facilitators and barriers of breastfeeding initiation among African American mothers from the perspective of subject matter experts (SMEs). This study was part of a larger study that also involved focus group methodology with African American women. The purpose of this article is to describe the opinions, knowledge, and perceptions of SMEs who work with African American mothers. A semistructured interview guide was used to interview 7 SMEs at which point no new themes emerged from the data. SMEs highlighted the significance of modifiable factors in breastfeeding initiation decisions and validated many perceptions of African American mothers. SMEs identified many critical issues foundational to community perspective and shaping future success in raising breastfeeding initiation rates. To increase breastfeeding initiation rates among African American mothers, strategies beyond the individual level are necessary. SMEs recognize the importance of addressing fundamental issues related to historical perspectives, normalization, education, and disparities in breastfeeding as critical.

Increasing Racial and Ethnic Diversity in the Nursing Workforce: One Pediatric Hospital's Strategic Approach.

BACKGROUND: The 2021 Future of Nursing Report 2020-2030: Charting a Path to Achieve Health Equity recognizes increasing racial and ethnic diversity in nursing as an imperative to achieving health equity. PRACTICE INITIATIVES: Over a 3-year period, nursing and human resource leaders at Boston Children's Hospital, a tertiary care, 454-bed pediatric academic medical center in Massachusetts, developed, implemented, and evaluated specific strategies to increase racial and ethnic diversity in recruitment and hiring of the nursing workforce. These specific strategies focused on cultivating partnerships, building relationships with candidates, and supporting transition into practice. RESULTS: Significant increases in racial and ethnic diversity recruitment and hiring were achieved over the 3-year period. In 2019, strategies yielded a 6% overall increase in total registered nurse diversity hiring with an 18% increase in new graduate diversity hires over 2018. In total, 16.2% of registered nurse hires for 2019 were racially and ethnically diverse. Subsequent years yielded similar success in the recruitment of diverse registered nurses. CLINICAL IMPLICATIONS: With the projected growth of racial and ethnic minority populations, nursing and health care leaders must prioritize intentional strategic diversity recruitment and retention actions to address this imperative to advance health equity through the creation of a racially and ethnically diverse nursing workforce.

Improving nurse retention in a large tertiary acute-care hospital.

In an era of constrained resources and shortages of nurses, reducing staff turnover and increasing satisfaction of RNs are critical. The authors discuss the implementation of 5 change concepts that resulted in a 91% reduction in voluntary nurse turnover, yielding a savings of $655,949.

Nurses' Views on Using Pasteurized Donor Human Milk for Hypoglycemic Term Infants.

PURPOSE: The purpose of this study was to explore maternal child nurses' knowledge and beliefs about using pasteurized donor human milk (PDHM) to treat newborns with hypoglycemia. Pasteurized donor human milk has been used for decades in neonatal intensive care units, but its use is relatively new in the well-baby population. STUDY DESIGN AND METHODS: Focus groups of maternal child nurses were conducted to explore this topic. RESULTS: Six focus groups that included a total 20 nurses were held. Four themes were identified: 1) nurses presumed safety of PDHM but lacked knowledge, 2) nurses' role as patient-family advocate, 3) nurses' logistical concerns about implementation of PDHM, and 4) nurses lacked clarity on formal milk sharing versus PDHM. CLINICAL IMPLICATIONS: As the use of PDHM increases for well babies, nurses will need more education about PDHM, its safety profile, its use in breastfeeding support and protection of the infant microbiome, and how PDHM differs from informal milk sharing. Nurses play an important role in helping parents weigh risks and benefits of using PDHM or formula when supplementation is needed during the hospital stay. It is important that nurses feel confident in their own knowledge and ability to address parental concerns so they can advocate for their patients and support parental decision-making.

Factors That Influence Breastfeeding Initiation Among African American Women.

OBJECTIVE: To examine cultural and socioenvironmental factors that affect breastfeeding initiation among African American women. DESIGN: Qualitative descriptive design and conventional content analysis. SETTING: A large, inner-city, primary care center affiliated with a 500-bed children's hospital within a large, Northeastern U.S. city. PARTICIPANTS: Participants were 34 U.S.-born African American mothers of healthy term infants 0 to 3 months of age. METHODS: Six focus groups were conducted using a 16-question, scripted interview guide. RESULTS: A number of complex factors that influenced breastfeeding initiation included certain cultural beliefs about sexuality, the influence of family and peer networks, information sources, intentions, and a variety of other barriers and facilitators. CONCLUSION: Our findings suggest that the decision to initiate breastfeeding is not solely determined by the woman within the African American community. Because this decision is contingent on multiple factors external to the woman, it is important to recognize the role that partners, grandmothers, communities, information sources, and health care providers/organizations play in women's decisions. Implementation of multilevel strategies is critical to increase breastfeeding initiation among African American mothers.