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Campo DC | Valor | Lengua/Idioma |
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dc.contributor.author | Ruzafa Martinez, Maria | - |
dc.contributor.author | Harillo Acevedo, Francisco David | - |
dc.contributor.author | Ramos Morcillo, Antonio Jesús | - |
dc.contributor.other | Facultades, Departamentos, Servicios y Escuelas::Departamentos de la UMU::Enfermería | es |
dc.date.accessioned | 2024-01-28T11:49:56Z | - |
dc.date.available | 2024-01-28T11:49:56Z | - |
dc.date.issued | 2021-05 | - |
dc.identifier.citation | Journal of Nursing Scholarship. 2021 May;53(3):358-368 | es |
dc.identifier.issn | 1547-5069 | - |
dc.identifier.issn | 1527-6546 | - |
dc.identifier.uri | http://hdl.handle.net/10201/137848 | - |
dc.description | ©2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Accepted, version of a Published Work that appeared in final form in Journal of Nursing Scholarship. To access the final edited and published work see https://doi.org/10.1111/jnu.12636 | es |
dc.description.abstract | Background: Current literature provides poor information about the implementation of health-promoting clinical practice guidelines (CPGs) and their longitudinal monitoring. Purpose: The aim of this study was to evaluate the longitudinal impact of a CPG implementation program that promotes breastfeeding, its associated quantitative and qualitative indicators, and direct costs. Design: A mixed-methods design with a longitudinal approach was utilized, with an interrupted time series design and the analysis of reports from the implementation program as the qualitative approach. Methods: The study setting was maternity and pediatric units of a health area in the Spanish health system. The implementation of a CPG for the promotion of breastfeeding was evaluated, which included a pre-implementation year (2011), 3 years of implementation (2012-2014), and 2 years of post-implementation (2015-2016). The sample was composed of mother-infant dyads. A segmented logistic regression analysis was utilized to evaluate the changes in the most important breastfeeding indicators. A deductive thematic content analysis was performed starting with quality indicators and a descriptive economic analysis. Findings: In the 6 years of monitoring, 7,842 mother-infant dyads were recorded. The results of the quantitative indicators showed the presence of four stages: baseline, gain, adjustment, and sustainability or saturation. The breast milk at the first feeding had an increasing slope in the gain stage (24% per quarter; odds ratio [OR] = 1.24, 95% confidence interval [CI] 1.12-1.37). The exclusive breastfeeding at hospital discharge showed significant changes in the period of gain (OR = 2.45, 95% CI 1.95-3.08), which was maintained in the adjustment period, with an increase of 18% in the slope of the gain stage (OR = 1.18, 95% CI 1.06-1.32). The longitudinal distribution of the qualitative indicators showed a greater concentration of indicators towards the first half of each phase. The total cost was 209,575€ ($248,670.17). Conclusions: The implementation of the breastfeeding CPG showed early, positive, and sustained results in the exclusive breastfeeding rates. The implementation implied the application of a complex intervention, with its qualitative indicators showing a wave-shaped dynamic. Clinical relevance: Our findings contribute to the understanding and evolution of the main indicators of the implementation of a breastfeeding CPG, providing details on the magnitude of the effect, the process of change, and the associated costs. | es |
dc.format | application/pdf | es |
dc.format.extent | 37 | es |
dc.language | eng | es |
dc.relation | Foundation for Healthcare Training and Research of the Murcia Region (FFIS), Grant FFIS/CE/02. | es |
dc.rights | info:eu-repo/semantics/openAccess | es |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | Breastfeeding | es |
dc.subject | Complex interventions | es |
dc.subject | Guidelines | es |
dc.subject | Implementation | es |
dc.subject | Implementation planning | es |
dc.subject | Implementation science | es |
dc.subject | Implementation strategies | es |
dc.subject | Time series | es |
dc.title | Monitoring of the Implementation of a Breastfeeding Guideline for 6 Years: A Mixed-Methods Study Using an Interrupted Time Series Approach | es |
dc.type | info:eu-repo/semantics/article | es |
dc.identifier.doi | https://doi.org/10.1111/jnu.12636 | - |
Aparece en las colecciones: | Artículos: Enfermería |
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