| Learning Session Dates for your Calendars |
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 April 27: Please mark your calendars and have as many of your team participate as possible in our next meeting by webinar from 2-4 pm. We will continue to focus on ways to increase frequency of feedings in the first 24 hours of life, as well as discuss documentation strategies. Click here to join the webinar. The phone conference number is 712-432-6100, access code 96875#.
May 3 or May 5: The second in-person learning session for this initiative will be held in Raleigh on May 3rd and repeated in Winston Salem on May 5th. Please have one member of your team click here to pre-register the members of your team who will attend this learning session. Registration closes on April 15.
June 22: Please mark your calendars and have as many of your team participate as possible in our final meeting by webinar from 2-4 pm. Connection information will be shared in future email.
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| The L-E-A-R-N Approach to Cultural Competence submitted by Emily Taylor, MPH |
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 Many of you report that the greatest source of unnecessary supplementation in your hospitals is maternal request, especially by Latinas who have concerns about the adequacy of their colostrum. I often hear the fatalistic phrase, "You can't change culture." And sure, if all of us approach every Latina with the expectation that she will supplement, then you're right: nothing will change.
But, what if we change our culture? In the coming weeks, I challenge you to exercise the LEARN approach to cultural competence in at least one patient per shift. Make it your practice - not just for Latinas, but teens, black women, white women, women with history of substance abuse - all women. Because you CAN change the culture of healthcare.
LEARN MODEL OF CULTURAL COMPETENCE
Listen (through an interpreter if need be) actively and respectfully. Expectat to learn from all human interactions.
Elicit Ask open-ended questions like, "What have you heard about breastfeeding?" or "What advice have you gotten from the women in your family?" Again, listen actively and affirm their statements as their truth. They may talk about wanting to fit in, wanting to use other drugs or medicines, having a history of trauma, or never knowing anyone who breastfed. All of these "barriers" can be flipped to facilitators.
Assess priorities, values and supports. Ask questions like, "Tell me about the people who will support you and your baby?;" "Will you be returning to work?;" and "What is the most important thing I can teach you before you leave the hospital?"
Recommend a simple plan of action such as "Spend lots of time skin-to-skin, and breastfeed your baby every time s/he shows a hunger cue [examples]. End the feeding when s/he shows that s/he is full [examples]." Then, follow up with questions like, "I want to make sure we understand each other. Can you tell me why it's important to have skin-to-skin time?" End by confirming the patient's involvement, "What do you think should be our next steps?" or "How are we going to make this plan happen?"
Normalize the process by emphasizing the normal that extends across all cultures: hunger and fullness, sleepiness and wakefulness, cluster feeding, etc. Make your message more concrete by using visuals. For example, if a mom says she doesn't have enough milk, you may show her the ball that shows how tiny the baby's belly is in the first days of life and assure her that she has enough milk to fill that tiny tummy. And, you may wish to show her how she can use her hands to express a drop - mother's own milk is a powerful visual!
Remember almost everyone learns best when: we know why we need to learn it, we can self-direct the process, we can use our previous experiences to make sense of the new experience and we are motivated because the issue is relevant and important in our lives.
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| Data |
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Teams have been forwarded the facility data we have in the electronic database and we hope you are discussing this in your home team meetings. For some teams the data will be less than helpful because of the low numbers of charts currently in the database. Please continue completing at least 2 charts each day and getting the data entered as soon as possible.
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| Announcement: NPIC/QAS Continuing Education Program: Addressing In-Hospital Newborn Falls |
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 This program will provide healthcare professionals with the current incidence on in-hospital newborn falls, factors that increase falls and potential interventions to prevent newborn falls. Click here for more information about this program.
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| Contact |
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 Karen Metzguer
PQCNC Improvement Advisor
metzguer@med.unc.edu
Work: 919-966-8391
Mobile: 919-619-6332
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