Research on the effect of evidence-based practice based on core competencies on improving breastfeeding counseling...

Although breastfeeding is widely encouraged, there are gaps between the knowledge and practice of good breastfeeding outcomes. Specifically, nurses' breastfeeding knowledge, skills and communication competency may be suboptimal. Competency-based, evidence-based interventions may address this issue; but their effectiveness is poorly understood.

To examine whether implementation of an evidence-based, core competency program was associated with changes in breastfeeding counselling practices among obstetric nurses and selected maternal breastfeeding outcomes.

This was a pre- and post-intervention study in a tertiary hospital. Evidence was searched from global guidelines and the literature, rated using tools, and translated into a competency framework based on the Knowledge-to-Action model. Nursing staff were provided with a tailored intervention program involving theoretical training, simulated skill practice, adoption of a standardized protocol and ongoing supervision. Practitioner, patient and system-level outcome indicators, including breastfeeding counseling skills, knowledge, skills, mother's breastfeeding ability and exclusive breastfeeding rates, were measured pre and post-intervention. The assessment was done through observation and checklists and descriptive and comparative statistics were used to analyse the data.

During the post-intervention assessment period, higher values were observed for all predefined practice indicators. Mothers receiving ≥6 counselling sessions increased from 22.0% to 88.0%, nurse training participation increased from 45.5% to 100.0%, effective breast-problem management increased from 70.0% to 100.0%, and exclusive breastfeeding during hospitalization increased from 26.0% to 50.0%. Maternal breastfeeding ability was reported as an ordinal outcome, with high ability increasing from 38.0% to 88.0%. Nurses' counselling competence scores increased descriptively from 102.09 ± 10.25 to 117.91 ± 8.62. These findings indicated that the implementation period was associated with higher observed knowledge, skills, and protocol-compliance indicators.

The findings suggested that a structured, competency-based, evidence-informed intervention may improve breastfeeding counselling competence among obstetric nurses and may support better maternal breastfeeding outcomes during hospitalization. However, because this was a single-center pre- and post-intervention study with a small sample and short follow-up, further controlled multicenter studies are needed to confirm the effectiveness and sustainability of the intervention.