Implementation of the Power Hour Campaign to Improve Early Breast Pumping Initiation Rates

To improve rates for early initiation of breast pumping among mothers who are separated from their newborns after giving birth at a Baby Friendly–certified hospital. To initiate the Power Hour campaign on the labor and delivery unit using Transforming Care at the Bedside principles. Before this initiative, initiation of breast pumping within 6 hours of birth was a mother/infant unit expectation for mothers who were separated from their newborns. Adherence was low and practice among nurses varied. The neonatal intensive care unit (NICU) lactation consultant provided evidence that supported early initiation of breast pumping, especially within the first hour, but this information did not change practice. Labor and delivery nurses who were motivated to support early initiation within the first hour encountered barriers. Breast pumps were stored in central supply, and pump kits were stored on the mother/infant unit. Mothers who pumped more than 6 hours after birth were dismayed at the small volumes of colostrum they were able to express. The Transforming Care at the Bedside team in collaboration with the advanced practice nurse leader took on this opportunity for improvement to provide the best in evidence‐based care to our new mothers. Breast pump kits and pumps are no longer stored in central supply, and par‐level inventory is maintained on the labor and delivery unit. The workflow changed from a multiple step process involving many departments to a single‐step process involving a trip to the storeroom. The time to obtain required supplies decreased from 60 minutes to 10 minutes. New mothers are shown models to demonstrate how small their newborn's stomachs are and to reassure them that they are producing enough colostrum. The process is hard wired into nursing workflow by adding early initiation of breast pumping to the order sets, electronic medical record documentation, and infant feeding guidelines. Audits of the electronic medical record were used to track compliance, and feedback from nurses guided any revisions needed to the new clinical practice. The nurse‐led campaign empowered nurses at the bedside to apply evidence‐based practice in their daily work. Rates of early initiation of breast pumping increased from 1% to 30% at 1 hour within a few months of implementation. Nurses at the bedside are experts in identifying opportunities for improvement in patient care and nursing workflow. Given the right tools, guidance, and time off from the unit, bedsid