Best practices make healthcare better

Barbara Davies and team

Barbara Davies’ experience as a nurse informs her scientific work on maternal and infant health.

by Matthew Bonsall

Nurses know that skin-to-skin contact between a mother and her baby immediately after birth reduces crying, improves mother-infant interaction, keeps the baby warm, and helps the mother to breastfeed successfully. Barbara Davies and her colleagues are working on ways to help nurses apply this kind of knowledge consistently, as a way to encourage breastfeeding. Their work is the latest in a series of projects by the Nursing Best Practice Research Unit (NBPRU), of the Faculty of Health Sciences, aimed at developing and promoting the most effective nursing practices. 

“We hope that taking a consistent approach based on best practices will increase breastfeeding rates. We’re helping nurses to assess what women want when it comes to breastfeeding,” Davies says. She’s a co-director of the Research Unit, a collaboration between researchers and educators at the University of Ottawa, and the Registered Nurses’ Association of Ontario (RNAO). The unit delivers state-of-the-art nursing knowledge based on the best available evidence. It also promotes collaboration and knowledge transfer with policymakers and social groups in Canada and around the world. 

The Montfort Hospital in Ottawa is one of nine Ontario sites participating in a study in collaboration with the NBPRU. One of the items selected for research at the Montfort is the RNAO breastfeeding guideline for nurses. It’s designed to find ways to help hospitals across Canada (and around the world) to support the World Health Organization’s (WHO) Baby-Friendly Initiative—a global effort launched by WHO and UNICEF to implement practices that protect, promote and support breastfeeding, the best way to provide newborns with the nutrients they need. WHO recommends exclusive breastfeeding until a baby is six months old, and continued breastfeeding with the addition of nutritious complementary foods for two years or beyond. 

The project brings Davies back to her nursing roots. Before her research career took off, she worked as a labour and delivery nurse in Toronto’s Women’s College Hospital in the 1970s. 

In keeping with the collaborative nature of the unit’s work, Davies and her colleagues engage nurses and other healthcare professionals on their own terms, instead of trying to impose solutions. “We recognize that nurses want to do the best they can for every patient, so we start by asking them what they want to do to improve,” Davies says. At the heart of the Montfort project is a hospital-based steering committee made up of nurses, physicians, lactation consultants, and administrators. 

Various evidence-based strategies are being used to facilitate knowledge transfer for nurses and multi-professional teams in the Montfort’s Family Birthing Centre. These strategies include developing unit policies and procedures, documentation tools, and materials to educate nurses and patients. To help ensure that best practices are adopted over the long term, evaluation methods are designed (with the help of IT staff) to help monitor changes, and to measure the impact on patient outcomes. 

The study also gives nurses a voice on fundamental questions, such as how they document their care. “We have nurses working with the Montfort’s IT people to design better charting systems,” Davies says. The two-year Montfort study is only halfway completed, and Davies says it would be premature to celebrate its achievements. But if the Research Unit’s track record is anything to go on, success will be the likely outcome. In the 2009-2010 fiscal year alone, the unit was involved in more than 170 research studies involving 10 universities and 52 members (both individuals and organizations). 

And the world is taking note of the unit’s list of accomplishments. The Honor Society of Nursing, Sigma Theta Tau International, selected the NBPRU and its RNAO partners, plus 21 other healthcare organizations, to share the inaugural Practice Academe Innovation Collaboration award. The Honor Society of Nursing is a global community of nurse leaders from 89 countries. The award, given last fall, recognizes the significance and value of collaborative efforts between nursing practice and academia to improve the health of people internationally. 

On a personal level, Davies was gratified to receive a Distinguished Alumnus Award from the University of Toronto’s Faculty of Nursing this spring. She was lauded for her contribution to basic and clinical research, and for her service as a role model for other healthcare professionals. 

Davies’ central role in the Nursing Best Practice Research Unit during its five-year existence has helped put the unit on the healthcare map. It has also laid the groundwork for the next stage in the unit’s evolution. “We’re applying to become a fully fledged research centre this fall,” Davies says. 

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