Breast milk is crucial to the health of the infants. Nurses are bound by evidence based practice to offer the best services to their patients and for the sake of infants ensure that they are well breasted and in the process they are not infected. The paper focuses on Santa Clara Valley Medical Center human milk collection, administration and storage policy and how it can be applied by nurses using the evidence based practice.
Breast milk storage should be done through clinically relevant interventions that govern the nursing evidence based practices. The cost effectiveness of these practices goes a long way in ensuring that breast milk is readily available without any risks to the infant. Breast milk storage also referred to as milk banking has raised a lot of debates with arguments by some people that it has the potential to spread diseases from the donor to the infants. There is some truth to this but some institutions like Santa Clara Valley Medical Center have a human milk collection, administration and storage policy. This works to eliminate any possibility of the milk transmitting illnesses to the infants who consume the milk.
It is crucial to note that donation of milk is a process that can be considered to be life-saving but there is a lack of the necessary information (Pediatric Nutrition Practice Group, 2011). Nevertheless, one realizes that research evidence on its own will not be good enough to ensure that a correct and appropriate clinical decision will be arrived to alleviate the challenges it faces. Nurses have a responsibility of ensuring that they balance the benefits and risks when dealing with a patient and in this case small children. The mother’s preferences and values should be put in consideration. The nurse has a role to see to it that the gains achieved by a management decision outweigh the loss. In evidence based nursing, it is all about making the right judgments for the good of the affected (Pediatric Nutrition Practice Group, 2011).
The root problem should be clearly defined. In this case, According to Palo Alto Medical Foundation (2012), donation of milk saves lives, and it is a process that lacks publicity; it is crucial that the society becomes aware of managing breast milk, the ways how it can be donated, and how it should be managed by those who receive the milk. The nursing communities in Santa Clara Valley Medical Center need to get the information necessary to manage the breast milk expressed. One of the roles of the nurses is to improve the life of the patients, and a major way to achieve this is through the education and information on milk banking (Molinari, Casadio, Arthur and Hartmann, 2011). For the evidence based solution however, it entailed involving research to find out the best evidence. One will weigh its implications putting in considerations the values of the subject. The breast milk in the bank is to be utilized in accordance with the California Tissue Bank License.
According to Dall’Oglio et al. (2009), evidence based practiced is only effective once used in accordance with its prescribed guidelines. Barriers can evoke at the individual or at an institutional levels. This is in cases where nurses may not be competent enough or lack the know-how on how to overcome challenges. This may be due to lack of confidence to handle change. Santa Clara Valley Medical Center policy on breast milk issues all the guidelines of the management of the milk that includes the guidance how the mothers should be provided with assistance as well as encouragement so that they provide their milk that will be used to feed the infants. The milk should be handled as it was blood, and it should not be allowed to be contaminated by foreign bodies. It should be handled with care including the use of gloves, and it should be stored at specified temperatures with intent of preventing the milk from spoiling. The milk should then be provided with a label that should have the name of the infant as well as the date when the milk was expressed.
The policy clearly stated that the milk that had not been labeled should not be administered to any infant. Nurses have cited a number of issues like the lack of time to read an update themselves with the new trends. Most facilities lack libraries or journals for this purpose. The organizations using this approach also have not been supportive enough since they have not strategized it properly (Cossey et al., 2011). At Santa Clara Valley Medical Center, the Mother’s Milk is usually the main source of all donor milk available for use in hospitals. Once the milk is expressed, it is screened for any abnormalities and then pasteurized to kill any germs present. The milk is then clearly labeled and stored in Lots which makes it easier to trace the source and date of expression. The pasteurized milk is finally issued to the infants’ ward where the nurses receive it. Upon receipt, the nurses at Santa Clara Valley Medical Center are supposed to transfer all the information on the donor milk to the infant’s file. In the case of donor milk, the Lot number has to be recorded and the milk is then screened for compatibility before the use. Once received, the donor milk is supposed to be transferred from the milk bank container to the individual containers bearing the infant’s identification. According to evidence based practices documentation of all information is crucial in proper maintenance of a patient (McKibbon, 1998).
Evidence based practices embrace the concept in which the nurses have access to the most recent type of evidence which should guide their activities during their clinical decision making. Evidence based practices have called for the review of the educational programs in terms of the curriculum that is offered (McKibbon, 1998). For total milk expression, Santa Clara Valley Medical Center advises that mothers pump their breasts at least 8-10 times within 24 hours to ensure that they get all the milk which is later bottled. Each bottle provided for milk collection carries approximately 2 ounces of milk which should then be well labeled with the provided labels which should clearly show the time and date of collection. If collected away from the hospital, then the milk has to be stored and transported to the hospital on ice. Containers for breast milk storage must be hard sided with air tight lids and are designed for single use, thus they must be discarded after one use. Rules on breast milk intended for use in hospital clearly state that milk collected at different times must not be combined in one container (Dall’Oglio et al., 2009).
Santa Clara Valley Medical Center Breast milk policy states that all the milk is stored in the hospital freezer where only the duty nurses are allowed access to minimize contamination. Frozen breast milk can be stored in the freezer for 24 hours, and thawed breast milk must be used within 24 hours after refrigeration (Neifert, 2011). It is also important to note that all breast milk for an individual infant must be stored in containers bearing amounts that the individual infant can consume at once. This cuts on the amount that is wasted when the infant is unable to finish the whole thawed amount. The nursing staff is supposed to instruct the mothers on the appropriate amounts of milk that their infants should consume at any given time (Spitzer, Doucet & Buettner, 2010). The evidence based practice has three underlying principles: practicing, researching and the education know how. This is the exact opposite of what is applied by the Santa Clara valley medical centre. They have specific guidelines that govern their day to day activities. New trends are not one of them.
Instructions on warming the frozen breast milk must also be well advised to the mothers. Santa Clara Valley Medical Center Breast milk policy advices that breast milk must never be warmed to a higher temperature that the body temperature while any thawed milk may be refrigerated but not refrozen. This has been their policy since time immemorial but the evidence based practice which I would prefer, would be effective if research based changes were introduced. The Santa Clara valley medical centre has not stated the effects of freezing the milk or having it in high temperatures.
The underlying principle in evidence based practices is the dire need of acquiring new information and trends to ensure that we research and involve the findings in our nursing practices. It is important for all the medical care staff and all the mothers to be well aware of all the information about the handling, storage, and administration of breast milk. This is because it is a human fluid that is prone to infections and thus must be well handled to ensure that the infants get all the nutrition from the milk they are fed. My goal is to work in OB as a RN. Hence, this topic has been very crucial to my future as RN; where, I will need to educate and answer mothers’ questions regarding this matter. This research and my experience should help educate others and myself and be a safe and helpful nurse. As a new nurse my role will be integrate EBP on my knowledge on clinical issues, values on the patients, research that is grounded on evidence that will assist in making decisions. I will request for guidance from experienced staff and employ my knowledge and clinical skills in assisting the infants and their mothers