Development of an implementation tool for a breast milk bank in the North West Province
Pretorius, Maria Alettha
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Background: Breast milk banks (BMBs) provide human donor breast milk to preterm infants when mothers are not able to provide breast milk themselves (Arslanoglu et al., 2010:20). Breastfeeding is the single most effective intervention to saving the lives of millions of children in developing countries (Bhutta & Labbok, 2011:378-380). BMBs form an integral part of the millennium development goals (MDGs) (Dempsey & Miletin, 2010:2) on reducing infant mortality and morbidity and are being implemented all over the world (Hartmann et al., 2007:667, Arslanoglu et al., 2010:20, Eidelman & Schanler 2012:827). Problem statement: BMBs can be established more effectively with an implementation tool in place. Currently, there is no tool available to guide the implementation of a BMB in South Africa; the only guidelines that could be found are those describing the operation of BMBs in other countries. Some of the BMBs already established in South Africa were implemented with the help of the South African Breast Milk Bank Reserve (SABR), but without a formalised guideline to provide implementation guidance. Aims and objectives: The purpose of this study was to adapt a current Kangaroo mother care (KMC) progress-monitoring tool and to adjust it according to the BMB setting in South Africa in order to provide a final suggested implementation tool for the implementation of BMBs. Method: An explorative, descriptive design with multiple phases was used. Different data sets were audited; including patient files, written reports, working files, research articles and policies. Observations were also made with regards to available equipment and designated BMB space. During phase one, a critical analysis was performed on research articles and websites regarding BMBs. The qualitative data was analysed by using content analysis. This information was adapted and contextualised in phase two. This phase entailed applying the adapted tool to the BMB setting of the selected regional hospital, which then led to phase three, in which the audited data was incorporated into the final suggested implementation tool resulting from this study. Results: The suggested tool, the North West Province BMB implementation tool, shared the six main constructs with the KMC progress-monitoring tool. The constructs are creating awareness, adopting the concept, taking ownership, evidence of practice, evidence of routine and integration and sustainable practice. However, some of the progress markers and instrument items were specifically relevant to the KMC setting and others to the BMB setting. On the other hand, some constructs overlapped, being relevant to both settings: for instance awareness by management, conscious decision to implement, mobilisation of resources (human, space and equipment), information about mothers’ other resources such as budget, patient records, staff orientation, evidence of discharge, policies and other written documents, and 1-2 year audit evidence and staff development. Conclusion: Adapting the KMC progress-monitoring tool led to the development of a suitable tool to guide BMB implementation. The tool is called the North West Province BMB implementation tool. This tool could be used to guide the implementation of a BMB in other hospitals in South Africa.
- Health Sciences